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Individual

ALLAN ROWAN KELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
929 COLLEGE AVE, FORT WORTH, TX 76104-3011
(817) 334-0003
(817) 334-0624
Mailing address
929 COLLEGE AVE, FORT WORTH, TX 76104-3011
(817) 334-0003
(817) 334-0624

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G6952
TX
207RI0200X
Infectious Disease Physician
G6952
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
114883503
TX
Enumeration date
06/09/2005
Last updated
06/12/2024
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