Individual
RICHARD DWAIN KELLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13435 N HWY 183 STE 311, AUSTIN, TX 78750-3258
(512) 614-1200
Mailing address
3401 ALDWYCHE DR, AUSTIN, TX 78704-5913
(512) 569-4457
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
L6457
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160443101
—
TX
Enumeration date
07/24/2006
Last updated
04/24/2017
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