1790171056 NPI number — ABEER A. KALDAS, MD, PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790171056 NPI number — ABEER A. KALDAS, MD, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ABEER A. KALDAS, MD, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1790171056
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/16/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6182 DUNBARTON OAK ST STE A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CORPUS CHRISTI
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78414-4276
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-500-4184
Provider Business Mailing Address Fax Number:
855-448-7791

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6182 DUNBARTON OAK ST STE A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CORPUS CHRISTI
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78414-4276
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
361-500-4184
Provider Business Practice Location Address Fax Number:
855-448-7791
Provider Enumeration Date:
04/13/2015

Additional Information

Authorized Official

Authorized Official Last Name:
KALDAS
Authorized Official First Name:
ABEER
Authorized Official Middle Name:
AMBER
Authorized Official Title or Position:
OWNER / CEO
Authorized Official Telephone Number:
806-773-8673

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  P5194 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 348382801 . This is a "MEDICAID LEGACY NUMBER" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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