Individual
KELLY E WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
7400 FANNIN SUITE 930, HOUSTON, TX 77054
(713) 796-8200
(713) 796-8203
Mailing address
6448 BROMPTON, HOUSTON, TX 77055
(713) 839-0581
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
J9443
TX
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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