Most Relevant Information
Provider Data
| NPI Number: | 1003319401 |
| Provider Name: | MARYJANE KELLER |
| Entity Type: | Individual |
| Taxonomy Code: | 363LA2200X |
| Specialty: | Nurse Practitioner |
| License Number: | AP106264 |
Most Important Dates
| Enumeration Date: | 03/12/2018 |
| Last Updated: | 03/12/2018 |
Provider Practice Location
6410 FANNIN ST STE 250
HOUSTON
TX
770303004
Practice Location Phone/Fax
| Phone: | 8323257131 |
| Fax: |
Provider Mailing Location
6410 FANNIN ST STE 250
HOUSTON
TX
770303004
Provider Mailing Phone/Fax
| Phone: | 8323257131 |
| Fax: |