Kelly G Thorstad MD PA

NPI #1063638443 in Austin, Texas

Provider Information

NPI Number: 1063638443
Entity Type: Organization
Organization Name: Kelly G Thorstad MD PA
Primary Specialty: Pediatrics
Enumeration Date: Apr 17, 2007
Last Updated: Jul 18, 2007

Practice Location

Address: 12120 RANCH ROAD 620 N
City: Austin
State: Texas
ZIP Code: 78750-1079
Phone: (512) 833-7334

Authorized Official

Name: DR. KELLY G THORSTAD, MD
Title: PHYSICIAN OWNER
Phone: (512) 833-7334

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pediatrics	208000000X	Primary

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