Provider Demographics
NPI:1194916379
Name:GILBERT-LEWIS, KIDADA NATAKI (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:KIDADA
Middle Name:NATAKI
Last Name:GILBERT-LEWIS
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9100 FONDREN RD
Mailing Address - Street 2:APT. 252
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-6999
Mailing Address - Country:US
Mailing Address - Phone:281-796-8651
Mailing Address - Fax:
Practice Address - Street 1:6411 FANNIN ST
Practice Address - Street 2:DEPARTMENT OF PATHOLOGY
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-5301
Practice Address - Fax:713-500-0732
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN2529207ZC0500X
TXBP1-0029089207ZC0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZC0500XAllopathic & Osteopathic PhysiciansPathologyCytopathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
4661832094OtherMYUTMB 4661832094