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Individual
TODD LAWRENCE KELLY
Active
Individual
TODD LAWRENCE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
K8775
TX
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
Primary
2019-00087
NC
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
K8775
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037266604
—
TX
05
—
037266605
—
TX
05
—
1306927900
—
NC
05
—
1888397
—
LA
05
—
37266601
—
TX
01
—
8AC774
BLUE CROSS
TX
01
—
P00616427
MEDICARE RAILROAD
TX
Enumeration date
10/18/2006
Last updated
06/14/2023
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