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Individual

DR. THOMAS E CALLAHAN III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
815 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2294
(817) 321-0404
Mailing address
816 W CANNON ST, FORT WORTH, TX 76104-3194
(817) 321-0404

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
M7890
TX
2085R0204X
Vascular & Interventional Radiology Physician
Primary
M7890
TX
2085R0204X
Vascular & Interventional Radiology Physician
MD-21591
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2107619
MA
01
462205
TUFTS
MA
01
AA64569
HARVARD PILGRIM HEALTHCAR
MA
01
J28704
BLUE CROSS BLUE SHIELD
MA
01
P00602905
RAILROAD MEDICARE
Enumeration date
06/13/2006
Last updated
04/07/2026
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