Provider Demographics
NPI:1487651691
Name:NARAYAN, KALMAN S (MD)
Entity Type:Individual
Prefix:DR
First Name:KALMAN
Middle Name:S
Last Name:NARAYAN
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 1:813 HEMPHILL ST
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-3108
Mailing Address - Country:US
Mailing Address - Phone:817-336-9055
Mailing Address - Fax:817-877-4943
Practice Address - Street 1:813 HEMPHILL ST
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-3108
Practice Address - Country:US
Practice Address - Phone:817-336-9055
Practice Address - Fax:817-877-4943
Is Sole Proprietor?:No
Enumeration Date:2005-07-01
Last Update Date:2008-04-30
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-05-25
Provider Licenses
StateLicense IDTaxonomies
TXE5868174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX031909701Medicaid
TX101928679OtherMEDICARE RR
TX101928679OtherMEDICARE RR
TXC19778Medicare UPIN