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General NPI Number Information
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NPI Number | 1023830619
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Entity Type | Individual
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Provider Name | KELSI S NELSON PTA
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Gender | Female
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Dates
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Enumeration Date | 10/25/2024
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Last Update Date | 10/25/2024
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Provider Practice Location Address
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Address Line | 20639 KUYKENDAHL RD STE 200
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City | SPRING
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State | TX
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Zip | 77379-3587
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Country | US
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Telephone | 281-364-1122
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Fax |
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Provider Business Mailing Address
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Address Line | 21810 GREENGATE DR
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City | SPRING
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State | TX
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Zip | 77388-3445
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Country | US
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Telephone | 832-296-3274
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2186218
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License Number State | TX
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