Provider Demographics
NPI:1740292622
Name:IRONS, KELLY D (LSA)
Entity type:Individual
Prefix:MR
First Name:KELLY
Middle Name:D
Last Name:IRONS
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1600 S COULTER ST STE B
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-0703
Mailing Address - Country:US
Mailing Address - Phone:806-354-2529
Mailing Address - Fax:806-467-9254
Practice Address - Street 1:1600 S COULTER ST STE B
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-0703
Practice Address - Country:US
Practice Address - Phone:806-354-2529
Practice Address - Fax:806-467-9254
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00076246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant