Individual
MRS. KELLY LANG HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1515 HOLCOMBE BLVD, HOUSTON, TX 77030-4000
(713) 792-6161
Mailing address
PO BOX 4439, HOUSTON, TX 77210-4439
(713) 792-2991
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP129313
TX
363L00000X
Nurse Practitioner
AP129313 /RN 788639
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
352550301
—
TX
01
—
8582NT
BCBS
TX
Enumeration date
11/03/2015
Last updated
01/14/2022
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