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General NPI Number Information
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NPI Number | 1710706635
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Entity Type | Individual
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Provider Name | SIMON PAUL KELLEY MBCHB, PHD, FRCS
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Gender | Male
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 6701 FANNIN STREET SUITE D.0650.15
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City | HOUSTON
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State | TX
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Zip | 77030
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Country | US
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Telephone | 713-447-6934
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Fax |
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Provider Business Mailing Address
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Address Line | 2455 DUNSTAN RD APT 420
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City | HOUSTON
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State | TX
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Zip | 77005
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Country | US
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Telephone | 647-239-6354
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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 | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | 48300
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License Number State | TX
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