Individual
DR. BRIAN DALE KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5323 HARRY HINES BLVD, DALLAS, TX 75390-7201
(214) 648-3111
Mailing address
PO BOX 845347, DALLAS, TX 75284-5347
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
N8412
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1005983
—
LA
Enumeration date
08/08/2007
Last updated
05/24/2012
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