Provider Demographics
NPI:1851787667
Name:KANDATHIPARAMPIL, ARLINE JOSE (MD)
Entity Type:Individual
Prefix:
First Name:ARLINE
Middle Name:JOSE
Last Name:KANDATHIPARAMPIL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 GROVEWAY DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77087-1122
Mailing Address - Country:US
Mailing Address - Phone:713-644-1568
Mailing Address - Fax:
Practice Address - Street 1:4501 GROVEWAY DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-1122
Practice Address - Country:US
Practice Address - Phone:713-644-1568
Practice Address - Fax:713-644-1864
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-08
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME144665208000000X
TXU5722208000000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108753300Medicaid