Provider Demographics
NPI:1457352981
Name:GIACALONE, DANA (DPM)
Entity Type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:GIACALONE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 IRA E WOODS AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-3906
Mailing Address - Country:US
Mailing Address - Phone:817-416-6155
Mailing Address - Fax:817-329-9434
Practice Address - Street 1:2421 IRA E WOODS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-3906
Practice Address - Country:US
Practice Address - Phone:817-416-6155
Practice Address - Fax:817-329-9434
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2007-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1738213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8H4553OtherBCBS
TXP000310043Medicare PIN
TX8H4553OtherBCBS
V05609Medicare UPIN