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General NPI Number Information
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NPI Number | 1609209949
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Entity Type | Individual
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Provider Name | DEEPTI KALLAM MD
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Gender | Female
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Dates
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Enumeration Date | 08/09/2013
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Last Update Date | 07/23/2024
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Provider Practice Location Address
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Address Line | 3107 W CAMP WISDOM RD STE 110
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City | DALLAS
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State | TX
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Zip | 75237-2600
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Country | US
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Telephone | 214-765-2222
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Fax | 214-269-9902
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Provider Business Mailing Address
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Address Line | 3107 W CAMP WISDOM RD STE 110
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City | DALLAS
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State | TX
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Zip | 75237-2600
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Country | US
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Telephone | 214-765-2222
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Fax | 214-269-9902
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | S1620
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | S1620
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 35C00445
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 35C000445
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License Number State | OH
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