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General NPI Number Information
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NPI Number | 1912245440
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Entity Type | Organization
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Legal Business Name | SENTINEL ANESTHESIA, PLLC
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Dates
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Enumeration Date | 01/17/2013
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Last Update Date | 01/17/2013
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Provider Practice Location Address
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Address Line | 16926 SOUTHWEST FREEWAY
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City | SUGARLAND
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State | TX
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Zip | 77479
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Country | US
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Telephone | 713-412-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 5118 YARWELL DR
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City | HOUSTON
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State | TX
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Zip | 77096-5314
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. TODD KELLY
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Credential | M.D.
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Telephone | 713-412-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | K8775
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License Number State | TX
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