Organization
KELLY BOURGEOIS M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRENE M. FONTENOT (ADMINISTRATOR)
(281) 580-9030
Entity
Organization
Contact information
Practice address
427 WEST 20TH #102, HOUSTON, TX 77008
(281) 580-9030
(281) 580-2725
Mailing address
PO BOX 73265, HOUSTON, TX 77273-3265
(281) 580-9030
(281) 580-2725
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
H9190
TX
Other
Enumeration date
02/20/2007
Last updated
08/22/2020
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