| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JAIDAH DENISE MCCALLON | 1386375673 | 2022-06-18 |
Jaidah Denise Mccallon is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1386375673. Registration indicates Jaidah Denise Mccallon is a provider of services with a specialization in Student, Health Care, Student in an Organized Health Care Education/Training Program (Student in an Organized Health Care Education/Training Program, ) (All Other Specialties & Provider Types, ) (Student in an Organized Health Care Education/Training Program, Student, Health Care)
| Entity Type | Individual |
| Provider Name | Jaidah Denise Mccallon |
| Practice Office Address | 5323 HARRY HINES BLVD DALLAS, TX US |
| Practice Office Telephone | 2146482168 |
| Practice Office Fax | 2146487517 |
| Mailing Address | 5323 HARRY HINES BLVD DALLAS, TX 753909006 US |
| Business Telephone | 2146482168 |
| Business Fax | 2146487517 |
| Code | Practice | License No State |
|---|---|---|
| 390200000X PRIMARY | Student, Health Care Student in an Organized Health Care Education/Training Program Student in an Organized Health Care Education/Training Program All Other Specialties & Provider Types Student in an Organized Health Care Education/Training Program Student, Health Care |