Organization
TJELMELAND PLASTIC SURGERY, P. A.
Active
Other names
Kelly E. Tjelmeland M. D.
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY E TJELMELAND M. D. (OWNER)
(512) 617-7500
Entity
Organization
Contact information
Practice address
4220 BULL CREEK RD, AUSTIN, TX 78731-6026
(512) 617-7500
Mailing address
4220 BULL CREEK RD, AUSTIN, TX 78731-6026
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
J7860
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
169603101
—
TX
01
—
8AQ830
BCBS INDIVIDUAL NUMBER
TX
Enumeration date
10/03/2006
Last updated
05/22/2008
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