Individual
DR. JACK EDWARD MCCALLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 STEVENS DR, BENBROOK, TX 76126-4407
(817) 249-8812
Mailing address
1 STEVENS DR, BENBROOK, TX 76126-4407
(817) 249-8812
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
E9301
TX
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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