MEDICARE: UNION MEDICAL CENTER PLLC

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	363L00000X	Nurse Practitioner
2	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1083453708
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNION MEDICAL CENTER PLLC

Provider Business Mailing Address
First Line	:	1605 N GARLAND AVE STE A
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75040-9418
Country	:	US
Telephone Number	:	214-501-4135
Fax Number	:	214-501-4134

Provider Business Practice Location Address
First Line	:	1605 N GARLAND AVE STE A
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75040-9418
Country	:	US
Telephone Number	:	214-501-4135
Fax Number	:	214-501-4134

Authorized Official
Title or Position	:	SOLE PROPRIETOR
Name	:	SERGIO CALIXTO-MONTANEZ
Credential	:	MD
Telephone Number	:	214-501-4135

Provider Enumeration Date	:	05/22/2024
Last Update Date	:	06/03/2025

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