MEDICARE: DR. CALVIN MIKE ASAY DDS

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	1223G0001X	General Practice Dentistry	22707	TX

General Provider Information

NPI Number	:	1902020779
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CALVIN MIKE ASAY DDS

Provider Business Mailing Address
First Line	:	16 CHISHOLM TRL
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-5043
Country	:	US
Telephone Number	:	512-244-2796
Fax Number	:	512-244-7334

Provider Business Practice Location Address
First Line	:	16 CHISHOLM TRL
Second Line	:
City	:	ROUND ROCK
State	:	TX
Zip	:	78681-5043
Country	:	US
Telephone Number	:	512-244-2796
Fax Number	:	512-244-7334

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	07/31/2007

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