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Individual

JAMES MATHEW KALLICKAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
ACAGNP

Contact information

Practice address
3406 BUSINESS CENTER DR, PEARLAND, TX 77584-4148
(346) 570-2284
Mailing address
1118 CONCORD PL, MISSOURI CITY, TX 77459-6770
(832) 263-0962

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
AP142979
TX
363LG0600X
Gerontology Nurse Practitioner
Primary
AP142979
TX

Other

Enumeration date
11/06/2019
Last updated
11/06/2019
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