Individual
KELLY PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
12850 MEMORIAL DR STE 210, HOUSTON, TX 77024-4973
(832) 827-4000
Mailing address
12850 MEMORIAL DR STE 210, HOUSTON, TX 77024-4973
(832) 827-4000
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
S4545
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2017
Last updated
03/22/2021
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