Individual
JEANA KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
6414 FANNIN ST STE G150, DEPARTMENT OF ORTHOPAEDIC SURGERY, HOUSTON, TX 77030-1514
(713) 486-7560
(713) 486-7512
Mailing address
6400 FANNIN ST STE 1700, HOUSTON, TX 77030-1526
(713) 500-3500
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA02880
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8N8730
BCBS
TX
Enumeration date
07/06/2006
Last updated
08/31/2022
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