Provider Demographics
NPI:1275511537
Name:ANGLIN-POINDEXTER, KELLY MICHOLE (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:MICHOLE
Last Name:ANGLIN-POINDEXTER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:NICHOLE
Other - Last Name:ANGLIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP-C
Mailing Address - Street 1:1500 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77587-4252
Mailing Address - Country:US
Mailing Address - Phone:713-946-7461
Mailing Address - Fax:713-946-7426
Practice Address - Street 1:1500 MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTH HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77587-4252
Practice Address - Country:US
Practice Address - Phone:713-946-7461
Practice Address - Fax:713-946-7426
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2022-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125478363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily