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Dr. Daniel H Kellum SR.
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NPI Number Detailed Information
Provider Information:
Name: | Dr. Daniel H Kellum SR. |
Gender: | M |
Provider License Number If Given: | E2252 |
NPI Information:
NPI: | 1174518625 |
Entity Type (Individual or Organization): |
1-ind |
Enumeration Date: | 9/12/2005 |
Last Update Date: | 2/10/2012 |
Provider Business Mailing Address:
Address: | 7323 MARBACH RD 104 San Antonio, TX 78227 |
Phone Number: | 2106740257 |
Fax Number: | 2106740619 |
Provider Business Practice Location Address:
Address: | 7323 MARBACH RD 104 San Antonio, TX 78227 |
Phone Number: | 2106740257 |
Fax Number: | 2106740619 |
Provider Taxonomy:
Primary: | 207Q00000X |
Secondary (if any): | |
State: | TX |