Individual
KELLEY MIA WARWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1901 SW H K DODGEN LOOP, TEMPLE, TX 76502-1814
(254) 771-8600
Mailing address
2211 STRATFORD DR, TEMPLE, TX 76502-3891
(832) 647-8180
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
M6455
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186374801
—
TX
01
—
8X9735
BCBS
TX
Enumeration date
06/11/2007
Last updated
03/05/2008
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