Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NR0400X | Rehabilitation Chiropractor | DC30938 | CA |
N | 111NS0005X | Chiropractic Sports Physician | 8575 | TX |
Y | 225100000X | Physical Therapist | 1219312 | TX |
NPI | 1124042106 |
---|---|
Provider Name | Dr. Chad Eric Kelly |
First Address | Houston, TX 77008-2400 |
Second Address | Houston, TX 77008-2400 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/07/2006 |
Last Update Date | 14/08/2017 |