Individual
JANICE MARIE KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
13323 DOTSON RD STE 200, HOUSTON, TX 77070-4303
(281) 970-6089
(281) 970-6105
Mailing address
PO BOX 90639, HOUSTON, TX 77290-0639
(281) 970-6089
(281) 970-6105
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
F6814
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45D1015567
CLIA WAIVER
TN
01
—
8J5580
BCBS PROVIDER NUMBER
TX
Enumeration date
09/17/2006
Last updated
03/19/2008
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