Kelly Bourgeois M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

H9190 Issued in TX

Legal business name

KELLY BOURGEOIS M.D.

Practice address

427 West 20TH #102
Houston, TX 77008

Phone

(281) 580-9030

Fax

(281) 580-2725

NPI assigned

Feb 20, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Irene M. Fontenot

Title

Administrator

Phone

(281) 580-9030

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1679617757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 73265",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772733265",
            "telephone_number": "281-580-9030",
            "fax_number": "281-580-2725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 WEST 20TH #102",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77008",
            "telephone_number": "281-580-9030",
            "fax_number": "281-580-2725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLY BOURGEOIS M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FONTENOT",
        "authorized_official_first_name": "IRENE",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "281-580-9030"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "H9190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Kellogg, PHD
• Lori Kellogg, LPC
• Carmisha Kellum, APRN, FNP-C
• Micah Kellum, CRNA
• Shania Nicole Kellum
• Kelly T.L. Tran, O.D., P.a.
• Kelly Zhao PLLC
• Sonya Kelly-Mothershed
• Vionna Kelly-Simeus, CSA
• Alexandra Leggett Kelly, PA-C

• Anesthesiology Physician in Houston, TX
• Providers in Houston, TX by specialty
• Anesthesiology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.