Sullivan, Kelly Ingrid

Sullivan, Kelly Ingrid is an individual health care provider with primary practice located at 1602 Rock Prairie Rd Suite 340, College Station TX 77845-8306. 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 / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Sullivan, Kelly Ingrid can be contacted via phone (979) 696-4440.

Contact Information

Primary practice address
1602 Rock Prairie Rd Suite 340 College Station TX 77845-8306
Phone: (979) 696-4440
Fax: (979) 696-7812
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 / Pediatrics 208000000X N1166 Texas

Profile Details

NPI number 1043492291
LBN Legal business name Sullivan, Kelly Ingrid
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 29th, 2007
Last updated May 21st, 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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