NPI 1083749824

Kelly's Primary Care, INC

Organisation Preferred Provider Organization Mission, TX

Practice location

Address: 2009 N Conway Ave, Mission, TX 78572-2965
Phone: (956) 583-0141
Fax: (956) 583-0143
Mailing address: 2007 N Conway Ave, Mission, TX 78572

Authorised official

Name: Jaynie Chapa
Title: Administrator
Phone: (956) 583-0141

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 006524 (TX)

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Registry record

NPI: 1083749824
Entity type: Organization
NPI issued: 22 Feb 2007
Record last updated: 7 Jun 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.