Provider Demographics
NPI:1487761961
Name:DESAI, KIRIT A (MD)
Entity type:Individual
Prefix:
First Name:KIRIT
Middle Name:A
Last Name:DESAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7737 SOUTHWEST FWY
Mailing Address - Street 2:#566
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1807
Mailing Address - Country:US
Mailing Address - Phone:713-988-6850
Mailing Address - Fax:713-988-6840
Practice Address - Street 1:7737 SOUTHWEST FWY
Practice Address - Street 2:#566
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1807
Practice Address - Country:US
Practice Address - Phone:713-988-6850
Practice Address - Fax:713-988-6840
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2015-09-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXF5889207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122077403Medicaid
TX122077403Medicaid