DEEPTI KALLAM (NPI# 1609209949) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609209949 |
| Entity Type | Individual |
| Full Name | DEEPTI KALLAM |
| Other Name | BALA DEEPTI GANGIREDDY |
| Credential | MD |
| Practice Address |
431 E State Highway 114 Ste 470 Southlake TX 76092-4415 |
| Mailing Address |
7415 Las Colinas Blvd Ste 100 Irving TX 75063-7569 |
| Practice Telephone | 2143792700 |
| Practice Fax Number | 9728693875 |
| Mailing Telephone | 2143792722 |
| Mailing Fax Number | 9728693875 |
| Enumeration Date | 2013-08-09 |
| Last Update Date | 2020-01-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RX0202X |
Internal Medicine Specialization: Medical Oncology |
S1620 | TX | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1501 Kings Hwy, Internal Medicine, Shreveport, LA 711034228 | 3188132528 | |
| 500 W Main St Ste 380, Lewisville, TX 750573606 | 2143792700 | 9728693875 |
| 7415 Las Colinas Blvd Ste 100, Irving, TX 750637569 | 2143792700 | 9728693875 |
| Street Address |
431 E STATE HIGHWAY 114 STE 470 |
| City | SOUTHLAKE |
| State | TX |
| Zip Code | 76092-4415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356388870 | James David Mackey | Internal Medicine | 431 E State Highway 114 Ste 470, Southlake, TX 76092-4415 | 2006-06-01 |
| 1003257957 | Amelia Brooke Tower | Surgery | 431 E State Highway 114 Ste 470, Southlake, TX 76092 | 2013-07-08 |
| 1225396039 | Swapna Goday | Internal Medicine | 431 E State Highway 114 Ste 470, Southlake, TX 76092-4415 | 2012-04-30 |
| 1124219449 | Raetasha Sheavette Dabney | Internal Medicine | 431 E State Highway 114 Ste 470, Southlake, TX 76092-4415 | 2007-08-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730718990 | Elizabeth Beazley | Family Medicine | 1050 E. Hwy 114 Suite 100, Southlake, TX 76092 | 2020-04-08 |
| 1518508894 | Arbor Pediatrics, Pllc | Pediatrics | 1130 N Kimball Ave, Southlake, TX 76092 | 2019-10-08 |
| 1346882685 | Gs Ortho Assists, Pllc | Physician Assistant | 2600 East Southlake Boulevard Suite 120, Southlake, TX 76092 | 2019-10-08 |
| 1609340496 | Rebecca Leigh Lander | Physician Assistant | 1170 N Carroll Ave., Southlake, TX 76092 | 2019-01-15 |
| 1225506223 | Physicians Wellness Associates Pllc | Family Medicine | 1920 East State Highway 114, Southlake, TX 76092 | 2018-11-07 |
| 1740762459 | Brandi L. Barker | Chiropractor | 590 N. Kimball Ave, Suite 140, Southlake, TX 76092 | 2018-08-30 |
| 1033699228 | Julie A. Seeber | Physical Therapy Assistant | 170 Stonebridge Lane, Southlake, TX 76092 | 2018-08-16 |
| 1992281364 | Alayna Powers | Nurse Practitioner | 900 E Southlake Blvd Ste 300, Southlake, TX 76092 | 2018-07-18 |
| 1346732153 | Amrittej Singh Virk | Dentist | 630 N Kimball Ave Ste 110, Southlake, TX 76092 | 2018-06-06 |
| 1740779594 | Radiant Family Dental Pllc | Dentist | 2012 Southlake Glen Dr., Southlake, TX 76092 | 2018-05-08 |
| Find all providers in zip 76092 | ||||
| Taxonomy Code | 207RX0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Medical Oncology |
| An internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source. 11/5/2007: corrected definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356388870 | James David Mackey | Internal Medicine | 431 E State Highway 114 Ste 470, Southlake, TX 76092-4415 | 2006-06-01 |
| 1518147594 | Southlake Oncology | Internal Medicine | 1545 E Southlake Blvd, Suite 280, Southlake, TX 76092-6465 | 2007-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447636857 | Carl Plager | Internal Medicine | 5151 Edloe Street, Apt. 5406, Houston, TX 77005-1187 | 2015-08-07 |
| 1730560525 | Michael Burgess | Internal Medicine | 300 Zapata Ave, Rancho Viejo, TX 78575-9654 | 2015-06-17 |
| 1861802332 | Shane Ahlers | Internal Medicine | 6037 Marquita Ave, Dallas, TX 75206 | 2014-05-05 |
| 1881018760 | Giora M. Mavligit | Internal Medicine | 2400 N. Braeswood, #211, Houston, TX 77030 | 2014-02-12 |
| 1396184354 | David Hsieh | Internal Medicine | 2201 Inwood Road 3rd Floor Nc3.500, Dallas, TX 75390 | 2013-06-22 |
| 1790124113 | William Stanley Gore | Internal Medicine | 570 Beechwood Loop, Hemphill, TX 75948-6615 | 2013-06-19 |
| 1679919963 | Olufunke Akinbobuyi | Internal Medicine | 2205 West Walker Street, League City, TX 77573 | 2013-05-14 |
| 1659715357 | Natasha Baldev Hirani | Internal Medicine | 1450 E League City Pkwy, League City, TX 77573 | 2013-04-24 |
| 1154676146 | Rossa Khalaf | Internal Medicine | 7812 Gateway Blvd E Ste 110, El Paso, TX 79915-1811 | 2012-07-17 |
| 1275808222 | Debra Louise Caudy | Internal Medicine | 6620 Golf Dr, Dallas, TX 75205-1212 | 2012-03-08 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.