Individual
KELSI VICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
205 N 11TH ST, BEAUMONT, TX 77702-2213
(409) 892-7090
(409) 892-4324
Mailing address
205 N 11TH ST, BEAUMONT, TX 77702-2213
(409) 892-7090
(409) 892-4324
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA17298
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/22/2022
Last updated
05/13/2026
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