Provider Demographics
NPI:1316266133
Name:KELLEY, JOHN P (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:P
Last Name:KELLEY
Suffix:
Gender:
Credentials:MD
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Mailing Address - Street 1:902 FROSTWOOD DR STE 302
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2428
Mailing Address - Country:US
Mailing Address - Phone:713-596-8526
Mailing Address - Fax:713-596-8560
Practice Address - Street 1:15400 SOUTHWEST FWY STE 125
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3879
Practice Address - Country:US
Practice Address - Phone:281-242-0131
Practice Address - Fax:281-242-7402
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP6844207K00000X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX322751402Medicaid