Individual
AJAY SHUBHADEEP KALLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3571 W WHEATLAND RD STE 101, DALLAS, TX 75237-3461
(972) 274-5555
(972) 274-5663
Mailing address
3571 W WHEATLAND RD STE 101, DALLAS, TX 75237-3461
(972) 274-5555
(972) 274-5663
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
Q6432
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05919
—
LA
Enumeration date
05/20/2008
Last updated
06/20/2018
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