MEDICARE: OMAR ANDRES CABALLERO

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	W3483	TX

General Provider Information

NPI Number	:	1528755576
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	OMAR ANDRES CABALLERO

Provider Business Mailing Address
First Line	:	2606 HOSPITAL BLVD STE B
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78405-1804
Country	:	US
Telephone Number	:	361-902-4789
Fax Number	:

Provider Business Practice Location Address
First Line	:	2606 HOSPITAL BLVD STE B
Second Line	:
City	:	CORPUS CHRISTI
State	:	TX
Zip	:	78405-1804
Country	:	US
Telephone Number	:	361-902-4789
Fax Number	:

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

Provider Enumeration Date	:	04/20/2023
Last Update Date	:	03/05/2026

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