Provider Demographics
NPI:1720346539
Name:UMHOLTZ, KELLY (AA-C)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:UMHOLTZ
Suffix:
Gender:F
Credentials:AA-C
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Mailing Address - Street 1:4747 BELLAIRE BLVD STE 580
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-4535
Mailing Address - Country:US
Mailing Address - Phone:713-659-3284
Mailing Address - Fax:713-664-2534
Practice Address - Street 1:6411 FANNIN ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-04-30
Last Update Date:2023-01-27
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367H00000XPhysician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant