Individual
KELLY ANNE AVERILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4502 MEDICAL DR, SAN ANTONIO, TX 78229-4402
(210) 358-5437
(210) 358-5483
Mailing address
7703 FLOYD CURL DR, SAN ANTONIO, TX 78229-3901
(210) 358-5437
Taxonomy
Speciality
Code
Description
License number
State
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
Q4892
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
347222701
—
TX
Enumeration date
07/19/2012
Last updated
09/08/2015
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