Individual
CRYSTAL DENISE KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
17500 W GRAND PKWY S, MEMORIAL HERMANN- SOUND PHYSICIANS, SUGAR LAND, TX 77479-2562
(281) 725-5070
(281) 725-5089
Mailing address
17500 W GRAND PKWY S, MEMORIAL HERMANN- SOUND PHYSICIANS, SUGAR LAND, TX 77479-2562
(281) 725-5070
(281) 725-5089
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
N3785
TX
208000000X
Pediatrics Physician
01055817A
IN
208000000X
Pediatrics Physician
036099345
IL
208000000X
Pediatrics Physician
N3785
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200273460
—
IN
Enumeration date
09/08/2005
Last updated
08/19/2010
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