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General NPI Number Information
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NPI Number | 1538308333
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Entity Type | Individual
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Provider Name | KELLEY L. BROOKS DDS
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Gender | Female
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Dates
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Enumeration Date | 02/18/2009
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Last Update Date | 02/18/2009
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Provider Practice Location Address
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Address Line | 4201 FM 1960 RD W SUITE 230
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City | HOUSTON
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State | TX
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Zip | 77068-3414
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Country | US
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Telephone | 281-537-1599
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Fax | 281-537-1310
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Provider Business Mailing Address
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Address Line | 25 NEEDHAM ST
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City | NEWTON
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State | MA
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Zip | 02461-1615
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Country | US
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Telephone | 617-964-6681
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Fax | 617-630-0141
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 20710
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License Number State | TX
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