Provider Demographics
NPI:1316584337
Name:BEZNER, KELSEY SUE
Entity Type:Individual
Prefix:MS
First Name:KELSEY
Middle Name:SUE
Last Name:BEZNER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2614 TAYLOR LN
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-5748
Mailing Address - Country:US
Mailing Address - Phone:832-231-5120
Mailing Address - Fax:
Practice Address - Street 1:8558 CREEKSIDE FOREST DR BLDG B
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77375-2175
Practice Address - Country:US
Practice Address - Phone:832-534-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-09
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical