Healthcare Provider Details

I. General information

NPI: 1861732802
Provider Name (Legal Business Name): SENTINEL CRITICAL CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2013
Last Update Date: 02/28/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7600 BEECHNUT ST
HOUSTON TX
77074-4302
US

IV. Provider business mailing address

5118 YARWELL DR
HOUSTON TX
77096-5314
US

V. Phone/Fax

Practice location:
  • Phone: 713-412-1200
  • Fax:
Mailing address:
  • Phone: 713-412-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberK8775
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TODD KELLY
Title or Position: OWNER
Credential: M.D.
Phone: 713-412-1200