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General NPI Number Information
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NPI Number | 1073005963
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Entity Type | Individual
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Provider Name | KELSEY WALKER MD
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Gender | Female
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Dates
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Enumeration Date | 06/06/2018
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Last Update Date | 05/30/2024
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Provider Practice Location Address
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Address Line | 1801 N HAMPTON RD
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City | DESOTO
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State | TX
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Zip | 75115-2391
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Country | US
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Telephone | 469-530-0376
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Fax |
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Provider Business Mailing Address
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Address Line | 312 ORCHARD PL
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City | RED OAK
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State | TX
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Zip | 75154-8861
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Country | US
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Telephone | 214-564-7365
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | T4083
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | T4083
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License Number State | TX
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