Provider Demographics
NPI:1174252282
Name:LIFETIME PRIMARY CARE
Entity Type:Organization
Organization Name:LIFETIME PRIMARY CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MISBAH
Authorized Official - Middle Name:
Authorized Official - Last Name:KALAIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:346-287-4512
Mailing Address - Street 1:16645 W AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77498
Mailing Address - Country:US
Mailing Address - Phone:346-287-4512
Mailing Address - Fax:832-308-1272
Practice Address - Street 1:16645 W AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77498
Practice Address - Country:US
Practice Address - Phone:346-287-4512
Practice Address - Fax:832-308-1272
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty