Provider Demographics
NPI:1336360619
Name:MCCALL & MCCALL
Entity Type:Organization
Organization Name:MCCALL & MCCALL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:JR
Authorized Official - Credentials:OD
Authorized Official - Phone:936-544-3763
Mailing Address - Street 1:711 E GOLIAD AVE
Mailing Address - Street 2:
Mailing Address - City:CROCKETT
Mailing Address - State:TX
Mailing Address - Zip Code:75835-2140
Mailing Address - Country:US
Mailing Address - Phone:936-544-3763
Mailing Address - Fax:936-544-7894
Practice Address - Street 1:711 E GOLIAD AVE
Practice Address - Street 2:
Practice Address - City:CROCKETT
Practice Address - State:TX
Practice Address - Zip Code:75835-2140
Practice Address - Country:US
Practice Address - Phone:936-544-3763
Practice Address - Fax:936-544-7894
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX185829201Medicaid
TX0555980001Medicare NSC
TX00X517Medicare PIN