Provider Demographics
NPI:1861660177
Name:CALVILLO DME
Entity Type:Organization
Organization Name:CALVILLO DME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:CALVILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-580-2535
Mailing Address - Street 1:1022 E GRIFFIN PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:MISSION
Mailing Address - State:TX
Mailing Address - Zip Code:78572-2401
Mailing Address - Country:US
Mailing Address - Phone:956-580-2535
Mailing Address - Fax:
Practice Address - Street 1:1022 E GRIFFIN PKWY STE 103
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:TX
Practice Address - Zip Code:78572-2401
Practice Address - Country:US
Practice Address - Phone:956-580-2535
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-20
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32034738321332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherIRS