Provider Demographics
NPI:1922407253
Name:K & L OBGYN INC
Entity Type:Organization
Organization Name:K & L OBGYN INC
Other - Org Name:KELLY J. MORALES, M.D., P.A.
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:JOANNE
Authorized Official - Last Name:MORALES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-692-0831
Mailing Address - Street 1:4499 MEDICAL DR
Mailing Address - Street 2:SUITE 191
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3735
Mailing Address - Country:US
Mailing Address - Phone:210-692-0831
Mailing Address - Fax:210-593-0211
Practice Address - Street 1:4499 MEDICAL DR
Practice Address - Street 2:SUITE 191
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3735
Practice Address - Country:US
Practice Address - Phone:210-692-0831
Practice Address - Fax:210-593-0211
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-22
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0980207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty