Basic Information
| Provider Information | |||||||||
| NPI: | 1952901324 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KALEMBA | ||||||||
| FirstName: | MICHAEL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17106 SCRAMBLE CT | ||||||||
| Address2: | |||||||||
| City: | SUGAR LAND | ||||||||
| State: | TX | ||||||||
| PostalCode: | 774984688 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8325455354 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9460 W SAM HOUSTON PKWY S | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770991850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815683134 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/27/2020 | ||||||||
| LastUpdateDate: | 10/27/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/27/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 37963 | TX | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.