Individual
DR. JACQUELINE KELLY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 E 8TH ST, G-159, AUSTIN, TX 78701-3233
(512) 587-0065
(512) 469-7854
Mailing address
904 W 30TH ST, AUSTIN, TX 78705-2104
(512) 587-0065
(512) 469-7854
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
F6266
TX
Other
Enumeration date
07/21/2005
Last updated
07/08/2007
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