Provider Demographics
NPI:1457596561
Name:CRAIG C CALLEWART MD PA
Entity type:Organization
Organization Name:CRAIG C CALLEWART MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:C
Authorized Official - Last Name:CALLEWART
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-271-4585
Mailing Address - Street 1:16970 DALLAS PKWY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1915
Mailing Address - Country:US
Mailing Address - Phone:214-271-4585
Mailing Address - Fax:214-271-4581
Practice Address - Street 1:9101 N. CENTRAL EXPWY.
Practice Address - Street 2:SUITE 360
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231
Practice Address - Country:US
Practice Address - Phone:214-271-4585
Practice Address - Fax:214-271-4581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-04
Last Update Date:2018-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH2283207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the SpineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6257900001Medicare NSC