Provider Demographics
NPI:1992745814
Name:CAVALLO, FRANCESCO M (MD)
Entity type:Individual
Prefix:
First Name:FRANCESCO
Middle Name:M
Last Name:CAVALLO
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:PO BOX 765
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46206-0765
Mailing Address - Country:US
Mailing Address - Phone:888-685-3915
Mailing Address - Fax:
Practice Address - Street 1:12121 RICHMOND AVENUE
Practice Address - Street 2:SUITE 109
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2420
Practice Address - Country:US
Practice Address - Phone:281-455-7618
Practice Address - Fax:281-781-2003
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ19192085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135024112Medicaid
TXF53423Medicare UPIN
TX135024112Medicaid