Individual
MRS. KELLI K LALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2401 S 31ST ST, TEMPLE, TX 76508-8602
(254) 724-2111
Mailing address
PO BOX 844658, DALLAS, TX 75284-7307
(254) 724-8800
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
325
MT
363AM0700X
Medical Physician Assistant
Primary
PA06756
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4308463
—
MT
Enumeration date
01/04/2007
Last updated
09/30/2020
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