Organization
KELSEY-SEYBOLD MEDICAL GROUP, PLLC
Active
Other names
Kelsey Seybold Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TAMICA WILSON (CREDENTIALING SPECIALIST)
(713) 442-4997
Entity
Organization
Contact information
Practice address
2727 W HOLCOMBE BLVD, HOUSTON, TX 77025-1669
(713) 442-0000
Mailing address
11511 SHADOW CREEK PARKWAY, ADMINISTRATIVE OFFICES, PEARLAND, TX 77584-7298
(713) 442-0000
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
207K00000X
Allergy & Immunology Physician
—
—
207N00000X
Dermatology Physician
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208C00000X
Colon & Rectal Surgery Physician
—
—
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112588201
—
TX
05
—
133543205
—
TX
05
—
154657401
—
TX
Enumeration date
07/12/2005
Last updated
07/22/2022
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