Basic Information
| Provider Information | |||||||||
| NPI: | 1962821017 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CALLEY | ||||||||
| FirstName: | CLIFFORD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6401 COLINA LN | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787594744 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2144053499 | ||||||||
| FaxNumber: | 5123807544 | ||||||||
| Practice Location | |||||||||
| Address1: | 1301 BARBARA JORDAN BLVD STE 200G | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787233078 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5126281855 | ||||||||
| FaxNumber: | 5136363980 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/15/2014 | ||||||||
| LastUpdateDate: | 10/01/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0402X | S5336 | TX | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology with Special Qualifications in Child Neurology |
No ID Information.