Individual
ALEXANDRA LEGGETT KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1700 POST OAK BLVD STE 11501160, HOUSTON, TX 77056-3963
(888) 663-6331
Mailing address
1700 POST OAK BLVD STE 11501160, HOUSTON, TX 77056-3963
(415) 658-6791
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
C07428
MD
363A00000X
Physician Assistant
Primary
PA12908
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
C0007428
MARYLAND DEPARTMENT OF HEALTH BOARD OF PHYSICIANS
MD
01
—
PA12908
TEXAS MEDICAL BOARD
TX
Enumeration date
11/18/2019
Last updated
08/26/2024
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