Provider Demographics
NPI:1487756094
Name:CALVO, DIONISIO B III
Entity type:Individual
Prefix:
First Name:DIONISIO
Middle Name:B
Last Name:CALVO
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1402 E 8TH ST
Mailing Address - Street 2:# 3
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6638
Mailing Address - Country:US
Mailing Address - Phone:956-968-6546
Mailing Address - Fax:
Practice Address - Street 1:1402 E 8TH ST
Practice Address - Street 2:# 3
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6638
Practice Address - Country:US
Practice Address - Phone:956-968-6546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-03
Last Update Date:2012-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7715207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123088004Medicaid
TX123088004Medicaid
00NL47Medicare PIN