Individual
KELLY W LOBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 JOSEPH DR, BRYAN, TX 77802-1502
(979) 821-7527
(979) 821-7528
Mailing address
PO BOX 4181, BRYAN, TX 77805-4181
(979) 821-7527
(979) 821-7528
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
K8939
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145512301
—
TX
01
—
1784755600
US DEPT OF LABOR
TX
01
—
4206261
BLUE LINK
TX
01
—
8AJ452
BLUE CROSS BLUE SHIELD OF TEXAS
TX
01
—
P00017074
MEDICARE RAILROAD
TX
Enumeration date
01/26/2006
Last updated
12/13/2021
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