Provider Demographics
NPI:1760035331
Name:KAIREXA HEALTHCARE PLLC
Entity Type:Organization
Organization Name:KAIREXA HEALTHCARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ABRAM
Authorized Official - Middle Name:A
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-360-1048
Mailing Address - Street 1:4720 N NESTING LN
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85718-6200
Mailing Address - Country:US
Mailing Address - Phone:520-360-1048
Mailing Address - Fax:
Practice Address - Street 1:4720 N NESTING LN
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85718-6200
Practice Address - Country:US
Practice Address - Phone:520-360-1048
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-22
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR37376OtherLICENSE