Provider Demographics
NPI:1699821413
Name:KALANTAR, JAMIE N (MD)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:N
Last Name:KALANTAR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 MASON ST
Mailing Address - Street 2:HOUSTON
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-2106
Mailing Address - Country:US
Mailing Address - Phone:713-533-0467
Mailing Address - Fax:
Practice Address - Street 1:2020 MASON ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-2106
Practice Address - Country:US
Practice Address - Phone:713-757-2887
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2009-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM4781207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX188254004OtherCSHCN
TX188254001Medicaid
TX188254005Medicaid
TX188254006Medicaid
TX8X6083OtherBCBS
TX188254009Medicaid
TX8AT552OtherBLUE CROSS BLUE SHIELD
TX8X6083OtherBCBS
TX8AT552OtherBLUE CROSS BLUE SHIELD
TX188254004OtherCSHCN
TX8J7594Medicare PIN