Healthcare Provider Details

I. General information

NPI: 1891228433
Provider Name (Legal Business Name): NISCHELLE KALAKOTA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 04/08/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 FONDREN RD STE 300
HOUSTON TX
77063-2313
US

IV. Provider business mailing address

PO BOX 631607
CINCINNATI OH
45263-1607
US

V. Phone/Fax

Practice location:
  • Phone: 713-730-2229
  • Fax: 713-334-5547
Mailing address:
  • Phone: 713-300-1123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberV1150
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberV1150
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: