Organization
KAHTAN A. KAISSI, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAHTAN A. KAISSI M.D. (PHYSICIAN)
(409) 722-3437
Entity
Organization
Contact information
Practice address
1300 FRANKLIN AVE, NEDERLAND, TX 77627-3949
(409) 722-3437
(409) 722-1281
Mailing address
1300 FRANKLIN AVE, NEDERLAND, TX 77627-3949
(409) 722-3437
(409) 722-1281
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
K1491
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8B4030
BCBS PROVIDER ID
TX
01
—
8B4031
BCBS PROVIDER ID NO.
TX
Enumeration date
01/02/2008
Last updated
08/03/2010
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