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General NPI Number Information
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NPI Number | 1174381792
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER J MICALLEF DO PLLC
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Dates
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Enumeration Date | 03/08/2024
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Last Update Date | 03/08/2024
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Provider Practice Location Address
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Address Line | 4372 N LOOP 1604 W STE 200
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City | SHAVANO PARK
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State | TX
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Zip | 78249-1201
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Country | US
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Telephone | 726-206-3484
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Fax | 210-547-0265
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Provider Business Mailing Address
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Address Line | 7600 BROADWAY APT 4008
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City | SAN ANTONIO
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State | TX
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Zip | 78209-1980
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Country | US
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Telephone | 937-830-4249
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Fax | 210-547-0265
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER JAMES MICALLEF
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Credential | DO
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Telephone | 937-830-4249
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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