| Shane M Kelly Dc Inc | |
|
1445 N Loop West, Suite 120, Houston, TX 77008-1654 | |
| (713) 864-9355 | |
| (713) 864-7211 |
| Full Name | Shane M Kelly Dc Inc |
|---|---|
| Type | Facility |
| Speciality | Chiropractor |
| Location | 1445 N Loop West, Houston, Texas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255515318 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 111N00000X | Chiropractor | TX8144 (Texas) | Primary |
| Provider Name | Shane Matthew Kelly |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1407941552 PECOS PAC ID: 0143264564 Enrollment ID: I20120328000777 |
| Mailing Address | Practice Location Address |
|---|---|
| Shane M Kelly Dc Inc 1445 N Loop West, Suite 120, Houston, TX 77008-1654 Ph: (713) 864-9355 | Shane M Kelly Dc Inc 1445 N Loop West, Suite 120, Houston, TX 77008-1654 Ph: (713) 864-9355 |
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