Kelsom Clinic Pa

LBN: Kelsom Clinic Pa
Kelsom Clinic Pa is an health care organization with primary practice located at 1202 W Pioneer Dr Suite 100, Irving TX 75061-7308. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Kelsom Clinic Pa can be contacted via phone (972) 254-7272, or through Okoronkwo, Catherine via phone (972) 254-7272.

Contact Information

Primary practice address
1202 W Pioneer Dr Suite 100 Irving TX 75061-7308
Phone: (972) 254-7272
Fax: (972) 254-7575
Website:
Map and Directions
Authorized official contact:
Name: Okoronkwo, Catherine Doctor of Medicine (MD)
Phone: (972) 254-7272

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X K2252 Texas

Profile Details

NPI number 1104840594
LBN Legal business name Kelsom Clinic Pa
DBA Doing business as
Authorized official Okoronkwo, Catherine Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 27th, 2006
Last updated Feb 9th, 2011 - about 13 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104840594 NPPES
Texas MEDICAID 160977801

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