Provider Demographics
NPI:1356361844
Name:KALLEL, ACCAMMA DAVID (NP)
Entity type:Individual
Prefix:
First Name:ACCAMMA
Middle Name:DAVID
Last Name:KALLEL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:ACCAMMA
Other - Middle Name:
Other - Last Name:OONNOONNY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN,MSN,ANP-C,CCRN
Mailing Address - Street 1:11704 STERLING BROOK ST
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-8754
Mailing Address - Country:US
Mailing Address - Phone:713-436-0933
Mailing Address - Fax:
Practice Address - Street 1:2002 HOLCOMBE BLVD
Practice Address - Street 2:MEDVAMC
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4211
Practice Address - Country:US
Practice Address - Phone:713-791-1414
Practice Address - Fax:713-794-7352
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX682976363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health