Provider Demographics
NPI:1366411225
Name:KALDIS, TERESA D (MD)
Entity type:Individual
Prefix:DR
First Name:TERESA
Middle Name:D
Last Name:KALDIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6560 FANNIN ST
Mailing Address - Street 2:SUITE 1878
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2761
Mailing Address - Country:US
Mailing Address - Phone:713-441-5189
Mailing Address - Fax:713-790-6604
Practice Address - Street 1:6560 FANNIN ST
Practice Address - Street 2:SUITE 1878
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2761
Practice Address - Country:US
Practice Address - Phone:713-441-5189
Practice Address - Fax:713-790-6604
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2017-01-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK1223208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8GD790OtherBCBS
TX8V8600OtherBLUE CROSS BLUE SHIELD
TX117759406Medicaid
TXH12483Medicare UPIN
TX8V8600OtherBLUE CROSS BLUE SHIELD
TX117759406Medicaid