Organization
KELLY G THORSTAD MD PA
Active
Other names
Lone Star Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLY G THORSTAD MD (PHYSICIAN OWNER)
(512) 833-7334
Entity
Organization
Contact information
Practice address
12120 RANCH ROAD 620 N, AUSTIN, TX 78750-1079
(512) 833-7334
(512) 833-7333
Mailing address
12120 RANCH ROAD 620 N, AUSTIN, TX 78750-1079
(512) 833-7334
(512) 833-7333
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L0651
TX
Other
Enumeration date
04/17/2007
Last updated
07/18/2007
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