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Individual

KELLY MARISSA COLEMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
10701 VINTAGE PRESERVE PKWY, HOUSTON, TX 77070-2158
(713) 442-1500
Mailing address
11511 SHADOW CREEK PKWY, PEARLAND, TX 77584-7298
(713) 442-0000

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M4740
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
215629102
TX
01
8X5380
BCBS
TX
Enumeration date
10/06/2006
Last updated
07/01/2021
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