Provider Demographics
NPI:1043343064
Name:CALZADA, PEDRO A (MD)
Entity type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:A
Last Name:CALZADA
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 1:147 W SUNSET RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-2080
Mailing Address - Country:US
Mailing Address - Phone:210-826-1215
Mailing Address - Fax:210-826-1241
Practice Address - Street 1:147 W SUNSET RD STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-2080
Practice Address - Country:US
Practice Address - Phone:210-826-1215
Practice Address - Fax:210-826-1241
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2976207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX211201302Medicaid
TX8EV214OtherBCBSTX
TXN2976OtherTX LICENSE
TX211201302Medicaid
TXN2976OtherTX LICENSE