Individual
CALVIN L CARGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 E I20, SUITE 104, STANTON, TX 79782
(432) 607-3243
(432) 607-3629
Mailing address
PO BOX 640, STANTON, TX 79782-0640
(432) 607-3243
(432) 607-3629
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H6093
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127408
CHIPS
TX
05
—
133360108
—
TX
01
—
141841001
EPSDT
TX
01
—
4366536
AETNA
TX
01
—
752616977066
TRICARE
TX
01
—
TIN PLUS SUFFIX 001
TRICARE
TX
01
—
TIN PLUS SUFFIX 043
TRICARE
TX
Enumeration date
02/10/2006
Last updated
12/02/2020
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