Individual
JOHN M KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1635 NORTH LOOP W, HOUSTON, TX 77008-1532
(713) 867-2066
Mailing address
909 FROSTWOOD DR STE 1.100, HOUSTON, TX 77024-2301
(713) 338-6353
(713) 704-3086
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD2007-0514
NM
207R00000X
Internal Medicine Physician
P3014
TX
208M00000X
Hospitalist Physician
Primary
P3014
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
683523
—
NM
Enumeration date
10/05/2005
Last updated
03/21/2020
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