MEDICARE: TROY L CALLAWAY MS LMFT PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1881200889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TROY L CALLAWAY MS LMFT PLLC

Provider Business Mailing Address
First Line	:	500 PLANTATION CT
Second Line	:
City	:	BURLESON
State	:	TX
Zip	:	76028-1489
Country	:	US
Telephone Number	:	214-926-2313
Fax Number	:	817-668-0527

Provider Business Practice Location Address
First Line	:	3901 W GREEN OAKS BLVD STE B
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76016-2789
Country	:	US
Telephone Number	:	817-946-2790
Fax Number	:	817-668-0527

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	TROY LEIGH CALLAWAY
Credential	:	LMFT
Telephone Number	:	817-946-2790

Provider Enumeration Date	:	09/16/2020
Last Update Date	:	10/22/2020

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