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Individual

SUSAN CALLAWAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3828 S 1ST ST, AUSTIN, TX 78704-7048
(512) 443-1311
(512) 445-6457
Mailing address
PO BOX 26726, AUSTIN, TX 78755-0726
(512) 407-8686
(512) 421-4489

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
E6269
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
105142701
TX
05
105142703
TX
05
105142704
TX
Enumeration date
07/31/2006
Last updated
12/09/2010
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