Provider Demographics
NPI:1992885339
Name:SMALKY, KATHLEEN ANNE (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:ANNE
Last Name:SMALKY
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
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Mailing Address - Street 1:1515 HOLCOMBE BLVD UNIT 1465
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-4000
Mailing Address - Country:US
Mailing Address - Phone:713-745-4516
Mailing Address - Fax:713-563-4491
Practice Address - Street 1:1515 HOLCOMBE BLVD UNIT 1465
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4000
Practice Address - Country:US
Practice Address - Phone:713-745-4516
Practice Address - Fax:713-563-4491
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2008-08-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH2787207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8W9692OtherBLUE CROSS BLUE SHIELD
TX045428205Medicaid
TX8K2688Medicare PIN