Individual
KENNETH LEE CALDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3919 WOODLAWN AVE STE B, PASADENA, TX 77504-1995
(281) 598-3638
(855) 592-2529
Mailing address
3636 OLD SPANISH TRL # 341, HOUSTON, TX 77021-2456
(713) 401-2896
(713) 359-2228
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
P8866
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114585395
TYPE 2-GROUP NPI
TX
05
—
146768079303
—
TX
01
—
83-4230855
TAX ID
TX
01
—
851963
INDIVIDUAL PTAN
TX
Enumeration date
06/25/2009
Last updated
09/13/2024
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