Organization
KELLY M RILEY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY MONIQUE RILEY OD (PRESIDENT)
(806) 637-3937
Entity
Organization
Contact information
Practice address
801 E TAHOKA RD, BROWNFIELD, TX 79316-3635
(806) 637-3937
(806) 637-3950
Mailing address
801 E TAHOKA RD, BROWNFIELD, TX 79316-3635
(806) 637-3937
(806) 637-3950
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6923TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2163347-01
—
TX
Enumeration date
08/18/2010
Last updated
02/24/2012
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