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Individual
KELLY BREE
Active
Individual
KELLY BREE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
S6139
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
415963401
—
TX
01
—
415963402
MEDICAID CSHCN
TX
01
—
8NJ637
BCBS
TX
01
—
Q00076452
RR MEDICARE
TX
Enumeration date
05/02/2014
Last updated
07/12/2021
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