Provider Demographics
NPI:1750640892
Name:KELLEY, ANGELA SIMMEN (MD)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:SIMMEN
Last Name:KELLEY
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4346, DEPT 5044
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77210
Mailing Address - Country:US
Mailing Address - Phone:713-300-1123
Mailing Address - Fax:
Practice Address - Street 1:911 W 38TH ST STE 402
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1122
Practice Address - Country:US
Practice Address - Phone:512-479-7979
Practice Address - Fax:512-479-7985
Is Sole Proprietor?:No
Enumeration Date:2012-05-10
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301100444207V00000X
TXS2080207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology