Provider Demographics
NPI:1033143516
Name:KELLEY, URSZULA BARBARA (MD)
Entity Type:Individual
Prefix:DR
First Name:URSZULA
Middle Name:BARBARA
Last Name:KELLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 974906
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75397-4906
Mailing Address - Country:US
Mailing Address - Phone:214-345-7355
Mailing Address - Fax:214-345-2682
Practice Address - Street 1:8200 WALNUT HILL LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4426
Practice Address - Country:US
Practice Address - Phone:214-345-7355
Practice Address - Fax:214-345-2682
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK25092084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0073CROtherBCBS
TX029931501Medicaid
TX00268DMedicare PIN
TXG67466Medicare UPIN