Provider Demographics
NPI:1174563605
Name:RICE-MONTEIRO, KELLIE A (DO)
Entity type:Individual
Prefix:
First Name:KELLIE
Middle Name:A
Last Name:RICE-MONTEIRO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4515 SETON CENTER PKWY
Mailing Address - Street 2:SUITE 215
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5290
Mailing Address - Country:US
Mailing Address - Phone:512-231-5506
Mailing Address - Fax:512-406-6216
Practice Address - Street 1:801 E WHITESTONE BLVD
Practice Address - Street 2:BLDG C
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-5028
Practice Address - Country:US
Practice Address - Phone:512-259-3467
Practice Address - Fax:512-406-7303
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2025-06-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA157546208000000X
TXM7569208000000X
NJ25MB11168000208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX192181901Medicaid
TX192181903Medicaid
TX192181902Medicaid
TX192181904Medicaid
TX192181903Medicaid
TXTXB119234Medicare PIN
TX192181901Medicaid
TX8K0006Medicare PIN