Individual
BLAIR WILLIAM KRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
214 PARKING WAY ST, LAKE JACKSON, TX 77566-5227
(979) 299-3376
(979) 299-3797
Mailing address
214 PARKING WAY ST, LAKE JACKSON, TX 77566-5227
(979) 299-3376
(979) 299-3197
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
L1637
TX
2084N0400X
Neurology Physician
Primary
L1637
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0035TD
MHS PHYS OF TX BCBSTX GRP PROV REC
TX
05
—
143723801
—
TX
01
—
302679101
MHS PHYS OF TX BRAZORIA MDCD GRP TPI
TX
Enumeration date
07/07/2005
Last updated
09/17/2024
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