Provider Demographics
NPI:1770786725
Name:KALU-EGWIM, STELLA U (MBBS)
Entity type:Individual
Prefix:DR
First Name:STELLA
Middle Name:U
Last Name:KALU-EGWIM
Suffix:
Gender:F
Credentials:MBBS
Other - Prefix:DR
Other - First Name:STELLA
Other - Middle Name:U
Other - Last Name:KALU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:1 BAYLOR PLZ
Mailing Address - Street 2:MS: BCM 320
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3498
Mailing Address - Country:US
Mailing Address - Phone:832-826-1385
Mailing Address - Fax:832-825-2799
Practice Address - Street 1:6621 FANNIN ST STE 6123
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2399
Practice Address - Country:US
Practice Address - Phone:832-826-1365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI48420-020208000000X
TXM8750208000000X, 208M00000X, 2080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX189589803Medicaid
TX189589803Medicaid
TX189589803Medicaid
TX00R518Medicare PIN