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NPI Code Detail

MEDICARE: DR. THERESA BRUNO CALIMLIM M.D.

MEDICARE: DR. THERESA BRUNO CALIMLIM 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
1208100000XPhysical Medicine & Rehabilitation Physician35.092111OH
22081H0002XHospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician35.092111OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1912113770
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THERESA BRUNO CALIMLIM M.D.
Provider Business Mailing Address
First Line : 1776 WOODSTEAD CT STE 208
Second Line :
City : THE WOODLANDS
State : TX
Zip : 77380-1480
Country : US
Telephone Number : 877-749-7428
Fax Number : 512-628-3314
Provider Business Practice Location Address
First Line : 1151 COLLEGE AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43209-2827
Country : US
Telephone Number : 877-749-7428
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 12/02/2025

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