MEDICARE: FRANCESCO M CAVALLO MD

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	2085R0202X	Diagnostic Radiology Physician	J1919	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1992745814
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANCESCO M CAVALLO MD

Provider Business Mailing Address
First Line	:	PO BOX 765
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46206-0765
Country	:	US
Telephone Number	:	888-685-3915
Fax Number	:

Provider Business Practice Location Address
First Line	:	12121 RICHMOND AVENUE
Second Line	:	SUITE 109
City	:	HOUSTON
State	:	TX
Zip	:	77082-2420
Country	:	US
Telephone Number	:	281-455-7618
Fax Number	:	281-781-2003

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

Provider Enumeration Date	:	06/08/2006
Last Update Date	:	06/20/2013

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