Provider Demographics
NPI:1528358017
Name:MARTIN, KAHLIL (MD)
Entity Type:Individual
Prefix:DR
First Name:KAHLIL
Middle Name:
Last Name:MARTIN
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 1:10111 RICHMOND AVE
Mailing Address - Street 2:#400
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77042-4215
Mailing Address - Country:US
Mailing Address - Phone:713-581-7090
Mailing Address - Fax:
Practice Address - Street 1:10111 RICHMOND AVE
Practice Address - Street 2:#400
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77042-4215
Practice Address - Country:US
Practice Address - Phone:713-581-7090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-18
Last Update Date:2011-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN9261207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology