Provider Demographics
NPI:1558305482
Name:KALLA, HARI KRISHNA (MD)
Entity Type:Individual
Prefix:DR
First Name:HARI
Middle Name:KRISHNA
Last Name:KALLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:1957 ANTILLEY RD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5208
Practice Address - Country:US
Practice Address - Phone:325-692-0188
Practice Address - Fax:325-698-4250
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL7769207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8U1532OtherBLUE CROSS OF TX
TX8U1532OtherBLUE CROSS OF TX
TX8G0859Medicare PIN
H15529Medicare UPIN