Provider Demographics
NPI:1952309577
Name:KALDIS, MICHAEL GREGORY (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GREGORY
Last Name:KALDIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:3302 PLUMB ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-2924
Mailing Address - Country:US
Mailing Address - Phone:713-333-4120
Mailing Address - Fax:713-333-4121
Practice Address - Street 1:6560 FANNIN ST
Practice Address - Street 2:SUITE 1016
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2761
Practice Address - Country:US
Practice Address - Phone:713-333-4120
Practice Address - Fax:713-333-4121
Is Sole Proprietor?:No
Enumeration Date:2005-07-08
Last Update Date:2012-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8208207X00000X, 207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F23895Medicare PIN
TX8C7155Medicare PIN
TXD87453Medicare UPIN