Provider Demographics
NPI:1548404080
Name:VARACALLI, KRISTIN (DO, MPH)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:VARACALLI
Suffix:
Gender:F
Credentials:DO, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1133 JOHN FREEMAN BLVD # 285A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2809
Mailing Address - Country:US
Mailing Address - Phone:713-500-5874
Mailing Address - Fax:743-500-0590
Practice Address - Street 1:1133 JOHN FREEMAN BLVD # 285A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2809
Practice Address - Country:US
Practice Address - Phone:713-500-5874
Practice Address - Fax:743-500-0590
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015736208100000X
TXS2189208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX403841601OtherTPI