| Roy L Caivano | |
|
714 Sw Wilshire Blvd Burleson TX 76028-5711 | |
| (817) 447-9900 | |
| (817) 447-5010 |
| Full Name | Roy L Caivano |
|---|---|
| Speciality | Internal Medicine |
| Location | 714 Sw Wilshire Blvd, Burleson, Texas |
| Authorized Official Name and Position | Roy L Caivano (OWNER) |
| Authorized Official Contact | 8174479900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roy L Caivano 714 Sw Wilshire Blvd Burleson TX 76028-5711 Ph: (817) 447-9900 | Roy L Caivano 714 Sw Wilshire Blvd Burleson TX 76028-5711 Ph: (817) 447-9900 |
| NPI Number | 1194920835 |
|---|---|
| Provider Enumeration Date | 06/20/2007 |
| Last Update Date | 08/21/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194920835 | NPI | - | NPPES |
| 178924001 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | M1052 (Texas) | Secondary |
| 207R00000X | Internal Medicine | J7923 (Texas) | Primary |
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