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Contact Information

KELLY BUCKHOLZ SMALLBECK
19428 I-45 NORTH
SPRING, TX77373
 Phone: 281-891-7084
 Fax: 281-891-7001
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for KELLY BUCKHOLZ SMALLBECK · (Female)

NPI # 1366948903
Status Active
Credentials
Entity Individual
Enumeration date 04/03/2018
Last updated 04/03/2018 - About 8 years ago
Sole proprietor 1 Yes
Identifiers
  • TX License # AT6095
  • Other 2000004828 ATHLETIC TRAINING BOARD OF CERTIFICATION
  • TX Other AT6095 TEXAS DEPARTMENT OF LICENSING AND REGULATION
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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