Provider Demographics
NPI:1346802220
Name:DEMELO, KELSY MORGAN (DC)
Entity Type:Individual
Prefix:DR
First Name:KELSY
Middle Name:MORGAN
Last Name:DEMELO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 W DALLAS ST APT 1034
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-4354
Mailing Address - Country:US
Mailing Address - Phone:774-526-3392
Mailing Address - Fax:
Practice Address - Street 1:2210 W DALLAS ST APT 1034
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-4354
Practice Address - Country:US
Practice Address - Phone:774-526-3392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-01
Last Update Date:2019-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14121111NR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0400XChiropractic ProvidersChiropractorRehabilitation