Provider Demographics
NPI:1295796431
Name:CALVO, RUSSELL DAVID JR (MD)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:DAVID
Last Name:CALVO
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:12812 HACIENDA RDG
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78738-7652
Mailing Address - Country:US
Mailing Address - Phone:512-563-5015
Mailing Address - Fax:512-597-2159
Practice Address - Street 1:12812 HACIENDA RDG
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78738-7652
Practice Address - Country:US
Practice Address - Phone:512-563-5015
Practice Address - Fax:512-597-2159
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-29
Last Update Date:2024-02-16
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Provider Licenses
StateLicense IDTaxonomies
TXF1427207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC14097Medicare UPIN