Provider Demographics
NPI:1821286444
Name:KELLI WATKINS MD PA
Entity Type:Organization
Organization Name:KELLI WATKINS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:V
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-981-7370
Mailing Address - Street 1:6200 W PARKER RD
Mailing Address - Street 2:SUITE 306 MOB 1
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-7914
Mailing Address - Country:US
Mailing Address - Phone:972-981-7370
Mailing Address - Fax:972-981-7371
Practice Address - Street 1:6200 W PARKER RD
Practice Address - Street 2:SUITE 306 MOB 1
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-7914
Practice Address - Country:US
Practice Address - Phone:972-981-7370
Practice Address - Fax:972-981-7371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0685207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty