MEDICARE: DEMARIO CALHOUN

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	251B00000X	Case Management Agency		TX
2	251S00000X	Community/Behavioral Health Agency		TX

General Provider Information

NPI Number	:	1154810935
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEMARIO CALHOUN

Provider Business Mailing Address
First Line	:	14175 DALLAS PKWY APT 1403
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75254-4414
Country	:	US
Telephone Number	:	318-518-6132
Fax Number	:

Provider Business Practice Location Address
First Line	:	14175 DALLAS PKWY APT 1403
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75254-4414
Country	:	US
Telephone Number	:	318-518-6132
Fax Number	:

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

Provider Enumeration Date	:	05/07/2018
Last Update Date	:	03/09/2026

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Directions to “ DEMARIO CALHOUN ” Practice Location

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