Healthcare Provider Details

I. General information

NPI: 1922398312
Provider Name (Legal Business Name): ALEXANDRA KATHLEEN CALLAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2011
Last Update Date: 12/04/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 INWOOD ROAD
DALLAS TX
75390-0014
US

IV. Provider business mailing address

1215 21ST AVENUE SOUTH MEDICAL CENTER EAST, SUITE 4200
NASHVILLE TN
37232
US

V. Phone/Fax

Practice location:
  • Phone: 214-645-1482
  • Fax: 214-645-3301
Mailing address:
  • Phone: 615-936-0100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberR3285
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: