Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 8198 | TX |
NPI | 1033210240 |
---|---|
Provider Name | James E Kelley |
First Address | El Paso, TX 79912-5487 |
Second Address | El Paso, TX 79912-5487 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/09/2006 |
Last Update Date | 08/07/2007 |