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General NPI Number Information
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NPI Number | 1124042106
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Entity Type | Individual
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Provider Name | CHAD ERIC KELLY D.C., P.T., D.P.T.
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 427 W 20TH ST STE 207
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City | HOUSTON
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State | TX
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Zip | 77008-2400
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Country | US
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Telephone | 713-961-7852
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Fax | 713-961-0812
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Provider Business Mailing Address
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Address Line | 427 W 20TH ST STE 207
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City | HOUSTON
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State | TX
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Zip | 77008-2400
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Country | US
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Telephone | 713-961-7852
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Fax | 713-961-0812
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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 | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | DC30938
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number | 8575
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1219312
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License Number State | TX
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