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Individual

KAMLESH THAKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
6565 FANNIN ST, SUITE B452, HOUSTON, TX 77030-2703
(713) 441-3620
Mailing address
6565 FANNIN ST, SUITE B452, HOUSTON, TX 77030-2703
(713) 441-3620

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
G9228
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
133735410
TX
05
133735411
TX
05
133735412
TX
05
133735413
TX
01
616192200
US DEPT OF LABOR
TX
01
8DY895
BLUE CROSS BLUE SHIELD
TX
01
8V3834
BLUE CROSS BLUE SHIELD
TX
01
P01030521
RR MEDICARE
TX
01
P01333570
RR MEDICARE
TX
Enumeration date
06/24/2006
Last updated
07/08/2016
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