Averill, Kelly Anne

Averill, Kelly Anne is an individual health care provider with primary practice located at 4502 Medical Dr , San Antonio TX 78229-4402. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology. Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology is her primary health care specialty. Averill, Kelly Anne can be contacted via phone (210) 358-5437.

Contact Information

Primary practice address
4502 Medical Dr San Antonio TX 78229-4402
Phone: (210) 358-5437
Fax: (210) 358-5483
Website:
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Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Neurology with Special Qualifications in Child Neurology 2084N0402X Q4892 Texas

Profile Details

NPI number 1306191879
LBN Legal business name Averill, Kelly Anne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2012
Last updated Sep 8th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306191879 NPPES
Texas MEDICAID 347222701

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