MEDICARE: DR. SERGIO CALIXTO-MONTANEZ M.D.

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	207Q00000X	Family Medicine Physician	P40031	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	:	1316268162
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SERGIO CALIXTO-MONTANEZ M.D.

Provider Business Mailing Address
First Line	:	6300 SAMUELL BLVD
Second Line	:	STE. 120
City	:	DALLAS
State	:	TX
Zip	:	75228-7137
Country	:	US
Telephone Number	:	214-381-1910
Fax Number	:	214-381-2868

Provider Business Practice Location Address
First Line	:	6300 SAMUELL BLVD
Second Line	:	STE. 120
City	:	DALLAS
State	:	TX
Zip	:	75228-7137
Country	:	US
Telephone Number	:	214-381-1910
Fax Number	:	214-381-2868

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

Provider Enumeration Date	:	06/16/2010
Last Update Date	:	11/25/2024

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