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Organization
PHILIP L KELTON JR MD PA
Active
Organization
PHILIP L KELTON JR MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP LLEWELLYN KELTON JR. MD (OWNER PRESIDENT)
(214) 826-8950
Entity
Organization
Contact information
Practice address
3600 GASTON AVE, WADLEY TOWER SUITE 1054, DALLAS, TX 75246-1910
(214) 826-8950
(214) 826-3434
Mailing address
3600 GASTON AVE LB-78, WADLEY TOWER SUITE 1054, DALLAS, TX 75246-1910
(214) 826-8950
(214) 826-3434
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
D7112
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04616699757
—
OK
05
—
115836201
—
TX
Enumeration date
04/03/2006
Last updated
08/20/2010
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