Provider Demographics
NPI:1841782380
Name:KAIROS HEALTH CLINICS
Entity Type:Organization
Organization Name:KAIROS HEALTH CLINICS
Other - Org Name:LAKEWOOD MED CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:R
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-867-3565
Mailing Address - Street 1:9101 LBJ FWY STE 310
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-1901
Mailing Address - Country:US
Mailing Address - Phone:469-437-4675
Mailing Address - Fax:469-437-4871
Practice Address - Street 1:6243 RETAIL RD STE 500
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-7808
Practice Address - Country:US
Practice Address - Phone:469-518-5580
Practice Address - Fax:844-589-8966
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-31
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0710207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty