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NPI Code Detail

MEDICARE: KELLY A TORNOW MD

MEDICARE: KELLY A TORNOW MD
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
12085N0700XNeuroradiology PhysicianQ3452TX
2390200000XStudent in an Organized Health Care Education/Training Program02037546TX
32085R0202XDiagnostic Radiology PhysicianQ3452TX

General Provider Information

NPI Number : 1467897793
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY A TORNOW MD
Provider Business Mailing Address
First Line : 1820 PRESTON PARK BLVD STE 2400
Second Line :
City : PLANO
State : TX
Zip : 75093-3716
Country : US
Telephone Number : 972-867-7862
Fax Number :
Provider Business Practice Location Address
First Line : 1820 PRESTON PARK BLVD STE 2400
Second Line :
City : PLANO
State : TX
Zip : 75093-3716
Country : US
Telephone Number : 972-867-7862
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/30/2013
Last Update Date : 09/26/2022

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Directions to “ KELLY A TORNOW MD” Practice Location

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