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Contact Information

KELLY'S PRIMARY CARE, INC
2009 N CONWAY AVE
MISSION, TX78572-2965
 Phone: 956-583-0141
 Fax: 956-583-0143
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for KELLY'S PRIMARY CARE, INC

NPI Number 1083749824
LBN Legal business name KELLY'S PRIMARY CARE, INC
Authorized official JAYNIE CHAPA - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 02/22/2007
Last updated 06/07/2011 - About 15 years ago
Identifiers
TX License # 006524
TX Medicaid 000017300
TX Medicaid 001012821
TX Medicaid 185365701
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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