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General NPI Number Information
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NPI Number | 1750640892
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Entity Type | Individual
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Provider Name | ANGELA SIMMEN KELLEY M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2012
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Last Update Date | 03/20/2025
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Provider Practice Location Address
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Address Line | 911 W 38TH ST STE 402
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City | AUSTIN
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State | TX
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Zip | 78705-1122
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Country | US
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Telephone | 512-479-7979
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Fax | 512-479-7985
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Provider Business Mailing Address
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Address Line | PO BOX 4346, DEPT 5044
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City | HOUSTON
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State | TX
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Zip | 77210
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Country | US
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Telephone | 713-300-1123
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 4301100444
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207VE0102X
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Taxonomy Name | Reproductive Endocrinology Physician
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License Number | S2080
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License Number State | TX
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