MEDICARE: SEBASTIAN CALVO

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	208100000X	Physical Medicine & Rehabilitation Physician	05616	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	82-1375206	OTHER	TX	CHIROPRATIC

General Provider Information

NPI Number	:	1700313103
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SEBASTIAN CALVO

Provider Business Mailing Address
First Line	:	7707 FANNIN ST STE 154
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1918
Country	:	US
Telephone Number	:	832-727-5056
Fax Number	:	713-501-8933

Provider Business Practice Location Address
First Line	:	7707 FANNIN ST STE 154
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1918
Country	:	US
Telephone Number	:	832-727-5056
Fax Number	:	713-501-8933

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

Provider Enumeration Date	:	05/16/2017
Last Update Date	:	05/16/2017

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Directions to “ SEBASTIAN CALVO ” Practice Location

Language	Start Address	Practice Location

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