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NPI Code Detail

MEDICARE: DR. MARIO J KELLY PHARM. D.

MEDICARE: DR. MARIO J KELLY PHARM. D.
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
1183500000XPharmacist44692TX

General Provider Information

NPI Number : 1184953630
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARIO J KELLY PHARM. D.
Provider Business Mailing Address
First Line : 500 MAXEY RD
Second Line :
City : HOUSTON
State : TX
Zip : 77013-5036
Country : US
Telephone Number : 713-330-4552
Fax Number :
Provider Business Practice Location Address
First Line : 500 MAXEY RD
Second Line :
City : HOUSTON
State : TX
Zip : 77013-5036
Country : US
Telephone Number : 713-330-4552
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2009
Last Update Date : 12/11/2009

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