Individual
BRENT CHRISTOPHER KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 772-2222
Mailing address
301 UNIVERSITY BLVD, GALVESTON, TX 77555-5302
(409) 772-2222
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
L4486
TX
207ND0900X
Dermatopathology Physician
L4486
TX
207R00000X
Internal Medicine Physician
L4486
TX
Other
Enumeration date
12/05/2006
Last updated
01/16/2024
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