Individual
DR. KELLY K. HAITHCOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6551 HARRIS PKWY, SUITE 200, FT WORTH, TX 76132-6103
(817) 423-1800
(817) 423-1900
Mailing address
6551 HARRIS PKWY, SUITE 200, FT WORTH, TX 76132-6103
(817) 423-1800
(817) 423-1900
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M3248
TX
Other
Enumeration date
05/09/2006
Last updated
07/08/2007
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