Provider Demographics
NPI:1912637406
Name:CALO, VICTORIA SANDRA
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:SANDRA
Last Name:CALO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SETON PKWY
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-8000
Mailing Address - Country:US
Mailing Address - Phone:443-253-8801
Mailing Address - Fax:
Practice Address - Street 1:201 SETON PKWY
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-8000
Practice Address - Country:US
Practice Address - Phone:512-324-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA17100363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant