Kelly G Thorstad Md Pa

NPI 1063638443 - Pediatrics - 208000000X

NPI Details
NPI 1063638443
Enumeration Date 04/17/2007
Last Updated 07/18/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name KELLY G KELLY
Position PHYSICIAN OWNER
Phone (512) 833-7334
Fax (512) 833-7333
Practice Location
12120 RANCH ROAD 620 N
AUSTIN TX, 78750-1079, US
Phone (512) 833-7334
Fax (512) 833-7333
Business Location
12120 RANCH ROAD 620 N
AUSTIN TX, 78750-1079, US
Phone (512) 833-7334
Fax (512) 833-7333
Toxanomy
Taxonomy Code 208000000X
License State Texas
License Number L0651
Remove 1063638443 NPI Number
 

According to our database, Kelly G Thorstad Md Pa NPI is 1063638443, taxonomy code is 208000000X and license number is L0651, license state is located at Texas. Kelly G Thorstad Md Pa physically located at 12120 Ranch Road 620 N, Austin TX, 78750-1079. NPI Number 1033115704 has the healthcare provider type.

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1063638443 NPI number is provided on an as is basis without warranty of any kind. 1063638443 is maintained by the National Plan & Provider Enumeration System. The contents of Kelly G Thorstad Md Pa are for informational purposes only.