DR. Kelly Gayle Thorstad, M.D.

NPI #1174508832 in Austin, Texas

Provider Information

NPI Number
1174508832
Entity Type
Individual
Name
DR. Kelly Gayle Thorstad, M.D.
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Pediatrics
Credential
M.D.
Enumeration Date
Dec 14, 2005
Last Updated
Jul 23, 2007

Practice Location

Address
12174 N MO PAC EXPY
Address 2
SUITE A
City
Austin
State
Texas
ZIP Code
78758-2910
Phone
(512) 833-7334

Specialties & Taxonomy Codes

Specialty
Pediatrics

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