MEDICARE: DR. MADISON ALYSSA CALAHAN PT, DPT

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	2251P0200X	Pediatric Physical Therapist

General Provider Information

NPI Number	:	1649060047
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MADISON ALYSSA CALAHAN PT, DPT

Provider Business Mailing Address
First Line	:	805 DELAWARE ST
Second Line	:
City	:	SHREVEPORT
State	:	LA
Zip	:	71106-1501
Country	:	US
Telephone Number	:	318-458-7075
Fax Number	:

Provider Business Practice Location Address
First Line	:	13201 NORTHWEST FWY STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-6012
Country	:	US
Telephone Number	:	832-209-7830
Fax Number	:

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

Provider Enumeration Date	:	05/08/2025
Last Update Date	:	05/08/2025

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