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NPI Code Detail

MEDICARE: KELLY L HUNTER PSYD

MEDICARE: KELLY L HUNTER PSYD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103T00000XPsychologist38496TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00998015OTHERTXRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
287968AOTHERTXBCBS

General Provider Information

NPI Number : 1114170305
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY L HUNTER PSYD
Provider Business Mailing Address
First Line : 12132 BELLA PALAZZO DR
Second Line :
City : FORT WORTH
State : TX
Zip : 76126-2134
Country : US
Telephone Number : 817-301-3621
Fax Number :
Provider Business Practice Location Address
First Line : 1300 S UNIVERSITY DR STE 306
Second Line :
City : FORT WORTH
State : TX
Zip : 76107-5746
Country : US
Telephone Number : 844-824-8775
Fax Number : 281-648-2200
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/31/2008
Last Update Date : 03/05/2025

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Directions to “ KELLY L HUNTER PSYD” Practice Location

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