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General NPI Number Information
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NPI Number | 1396703849
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Entity Type | Organization
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Legal Business Name | PATRICK F KELLY DO
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 08/06/2008
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Provider Practice Location Address
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Address Line | 4375 BOOTH CALLOWAY RD SUITE 410
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-8359
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Country | US
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Telephone | 817-595-5890
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Fax | 817-595-7642
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Provider Business Mailing Address
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Address Line | 4375 BOOTH CALLOWAY RD SUITE 410
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City | NORTH RICHLAND HILLS
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State | TX
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Zip | 76180-8359
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Country | US
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Telephone | 817-595-5890
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Fax | 817-595-7642
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Authorized Official
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Title or Position | OWNER
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Name | DR. PATRICK F KELLY
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Credential | D.O.
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Telephone | 817-595-5890
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K5127
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License Number State | TX
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