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Individual

ETHAN KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
18511 HIGHLANDER MEDICS ST, FORT BLISS, TX 79906-5327
(915) 742-7777
Mailing address
18511 HIGHLANDER MEDICS ST, FORT BLISS, TX 79906-5327
(915) 742-7777

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
V8298
TX

Other

Enumeration date
03/02/2022
Last updated
08/28/2025
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