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Individual

DR. DAVID B KELLEY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHD

Contact information

Practice address
1010 FIR LN, LOCKHART, TX 78644-2059
(512) 398-4896
Mailing address
815 W PRAIRIE LEA ST, LOCKHART, TX 78644-2555
(512) 398-4896
(512) 398-4896

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
31422
TX
103TC0700X
Clinical Psychologist
31422
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000042ME
BCBS PRIVATE PRACTICE
TX
05
1409500-02
TX
Enumeration date
06/12/2006
Last updated
03/27/2017
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