Provider Demographics
NPI:1821778499
Name:TERRELL, CALLIE ANN (AUD)
Entity Type:Individual
Prefix:
First Name:CALLIE
Middle Name:ANN
Last Name:TERRELL
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12314 ELLA LEE LN
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-5914
Mailing Address - Country:US
Mailing Address - Phone:281-451-6370
Mailing Address - Fax:
Practice Address - Street 1:8410 DATAPOINT DR STE 150
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4002
Practice Address - Country:US
Practice Address - Phone:210-617-5300
Practice Address - Fax:210-949-8933
Is Sole Proprietor?:No
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1347A231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist