Kelly, Crystal Denise

Kelly, Crystal Denise is an individual health care provider with primary practice located at 17500 W Grand Pkwy S Memorial Hermann- Sound Physicians, Sugar Land TX 77479-2562. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is her primary health care specialty. Kelly, Crystal Denise can be contacted via phone (281) 725-5070.

Contact Information

Primary practice address
17500 W Grand Pkwy S Memorial Hermann- Sound Physicians Sugar Land TX 77479-2562
Fax: (281) 725-5089
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 036099345 Illinois
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 01055817A Indiana
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X N3785 Texas
Allopathic & Osteopathic Physicians / Pediatrics 208000000X N3785 Texas

Profile Details

NPI number 1538153283
LBN Legal business name Kelly, Crystal Denise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 8th, 2005
Last updated Aug 19th, 2010 - about 14 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 1538153283 NPPES
Indiana MEDICAID 200273460

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