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Individual

KELLY W. BLEVINS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
9305 PINECROFT DR STE 400, THE WOODLANDS, TX 77380-3482
(713) 486-8800
(281) 367-1323
Mailing address
6400 FANNIN ST STE 1700, HOUSTON, TX 77030-1526
(713) 486-8800
(281) 367-1323

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
J9468
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
096697002
TX
Enumeration date
08/29/2005
Last updated
07/18/2022
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