Provider Demographics
NPI:1215060082
Name:CALDWELL, TROY (MD)
Entity type:Individual
Prefix:DR
First Name:TROY
Middle Name:
Last Name:CALDWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2609 SHERRILL PARK DR
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75082-3215
Mailing Address - Country:US
Mailing Address - Phone:972-231-4469
Mailing Address - Fax:
Practice Address - Street 1:379 FM 2972
Practice Address - Street 2:B POD ADMINISTRATIVE AREA
Practice Address - City:RUSK
Practice Address - State:TX
Practice Address - Zip Code:75785-0999
Practice Address - Country:US
Practice Address - Phone:903-683-5781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE83722084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXZOOOPJ484Medicaid
TXZOOOPJ484Medicaid
TXZOOOPJ484Medicaid
TXAC-7805217OtherDEA #