Doctor Name: | DR. KELLI O STEVENS |
NPI Number: | 1215296728 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | D.P.M. |
License Number: | 2075 |
Business Practice Address: | 345 E Parkwood Ave Friendswood, TX - 775465147 |
Business Phone Number: | 2819920006 |
Business Fax Number: | 2819920009 |
Mailing Address: | 345 E Parkwood Ave, FRIENDSWOOD |
State: | TX |
Postal Code: | 775465147 |
Phone Number: | 2819920006 |
Fax Number: | 2819920009 |
NPI Enumeration Date: | 05/04/2012 |
NPI Last Update Date: | 09/15/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 213ES0103X |
License Number: | 2075 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
Taxonomy Classification: | Podiatrist |
Taxonomy Specialization: | Foot & Ankle Surgery |
Taxonomy Definition: |