Provider Demographics
NPI:1902470164
Name:ALBRECHT, KELLY DAWN (MD, FRCSC)
Entity Type:Individual
Prefix:DR
First Name:KELLY
Middle Name:DAWN
Last Name:ALBRECHT
Suffix:
Gender:F
Credentials:MD, FRCSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6651 MAIN STREET 10TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030
Mailing Address - Country:US
Mailing Address - Phone:346-221-4250
Mailing Address - Fax:
Practice Address - Street 1:6651 MAIN STREET 10TH FLOOR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030
Practice Address - Country:US
Practice Address - Phone:713-798-5928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-13
Last Update Date:2024-03-22
Deactivation Date:2023-03-23
Deactivation Code:
Reactivation Date:2023-05-03
Provider Licenses
StateLicense IDTaxonomies
GA98774207VM0101X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine