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General NPI Number Information
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NPI Number | 1083620363
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Entity Type | Individual
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Provider Name | SUSAN CALLAWAY MD
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 12/09/2010
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Provider Practice Location Address
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Address Line | 3828 S 1ST ST
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City | AUSTIN
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State | TX
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Zip | 78704-7048
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Country | US
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Telephone | 512-443-1311
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Fax | 512-445-6457
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Provider Business Mailing Address
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Address Line | PO BOX 26726
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City | AUSTIN
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State | TX
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Zip | 78755-0726
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Country | US
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Telephone | 512-407-8686
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Fax | 512-421-4489
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | E6269
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License Number State | TX
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