Provider Demographics
NPI:1750820650
Name:CALLENDER, KERRY DAVID DAVID
Entity Type:Individual
Prefix:
First Name:KERRY DAVID
Middle Name:DAVID
Last Name:CALLENDER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4806 DENVER DR
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77551-5935
Mailing Address - Country:US
Mailing Address - Phone:409-539-1555
Mailing Address - Fax:
Practice Address - Street 1:4806 DENVER DR
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77551-5935
Practice Address - Country:US
Practice Address - Phone:409-539-1555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer