Provider Demographics
NPI:1104839455
Name:CALHOUN, RICK L (FNP)
Entity type:Individual
Prefix:
First Name:RICK
Middle Name:L
Last Name:CALHOUN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 W CHAPMAN DR STE 500
Mailing Address - Street 2:
Mailing Address - City:SANGER
Mailing Address - State:TX
Mailing Address - Zip Code:76266-8302
Mailing Address - Country:US
Mailing Address - Phone:940-458-2044
Mailing Address - Fax:940-458-2014
Practice Address - Street 1:1650 W CHAPMAN DR STE 500
Practice Address - Street 2:
Practice Address - City:SANGER
Practice Address - State:TX
Practice Address - Zip Code:76266-8302
Practice Address - Country:US
Practice Address - Phone:940-458-2044
Practice Address - Fax:940-458-2014
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX643565363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX182454201Medicaid
TX182454201Medicaid
TXQ18386Medicare UPIN
TX8G8176Medicare PIN