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Organization
MARISE KELLY, M.D., P.A.
Active
Organization
MARISE KELLY, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARISE KELLY M.D. (DIRECTOR)
(713) 928-2774
Entity
Organization
Contact information
Practice address
900 BROADWAY ST, HOUSTON, TX 77012-2127
(713) 928-2774
(713) 928-2781
Mailing address
900 BROADWAY ST, HOUSTON, TX 77012-2127
(713) 928-2774
(713) 928-2781
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J9727
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
219659401
—
TX
05
—
219659402
—
TX
Enumeration date
10/05/2009
Last updated
05/27/2011
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