Provider Demographics
NPI:1629246855
Name:MALLIKA KAMANA MD PA
Entity Type:Organization
Organization Name:MALLIKA KAMANA MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:MALLIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:KAMANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-409-4090
Mailing Address - Street 1:PO BOX 58848
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77258-8848
Mailing Address - Country:US
Mailing Address - Phone:281-557-8300
Mailing Address - Fax:281-557-8335
Practice Address - Street 1:17490 HIGHWAY 3
Practice Address - Street 2:SUITE 100-B
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4160
Practice Address - Country:US
Practice Address - Phone:281-557-8300
Practice Address - Fax:281-557-8335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2012-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0772207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI33610Medicare UPIN