Individual
MAMTA KALIDAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12221 N MO PAC EXPY, AUSTIN, TX 78758-2401
(512) 901-4008
Mailing address
12221 N MO PAC EXPY, AUSTIN, TX 78758-2401
(512) 901-4008
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
L1904
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149156503
—
TX
Enumeration date
10/17/2006
Last updated
03/26/2009
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