IndividualActive
Brooks Kelly, MD
NPI 1770148066 · Plastic and Reconstructive Surgery Physician · Southlake, TX
Provider details
- NPI number
- 1770148066
- Entity type
- Individual
- Primary specialty
- Plastic and Reconstructive Surgery PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 0116032687 (VA)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
415 E Southlake Blvd Ste 101
Southlake, TX 76092-6279
Phone: (817) 809-3155
Approximate (ZIP-level) locationGet directions
Mailing address
415 E Southlake Blvd Ste 101
Southlake, TX 76092-6279
Registry dates
- Enumerated
- 2019-05-02
- Last updated
- 2025-06-19
- Certified
- 2025-06-19
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.