MEDICARE: JAMES M. CALLOWAY

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	101YP2500X	Professional Counselor	16448	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	:	1013078096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES M. CALLOWAY

Provider Business Mailing Address
First Line	:	PO BOX 696
Second Line	:
City	:	MOUNT ENTERPRISE
State	:	TX
Zip	:	75681-0696
Country	:	US
Telephone Number	:	903-822-4014
Fax Number	:

Provider Business Practice Location Address
First Line	:	704 W RUSK ST
Second Line	:
City	:	MOUNT ENTERPRISE
State	:	TX
Zip	:	75681-7427
Country	:	US
Telephone Number	:	903-822-4014
Fax Number	:

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	10/29/2007

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Directions to “ JAMES M. CALLOWAY ” Practice Location

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