Brooks Brenden Kelly, MD

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

V6040 Issued in TX

Practice address

415 E Southlake Blvd Ste 101
Southlake, TX 76092-6279

Phone

(817) 809-3155

NPI assigned

May 2, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: bkelly1442739@direct.sw.org

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

{
    "created_epoch": "1556755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750291200000",
    "number": "1770148066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 E SOUTHLAKE BLVD STE 101",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926279",
            "telephone_number": "817-809-3155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 E SOUTHLAKE BLVD STE 101",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926279",
            "telephone_number": "817-809-3155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "BROOKS",
        "middle_name": "BRENDEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-02",
        "last_updated": "2025-06-19",
        "certification_date": "2025-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "VA",
            "license": "0116032687",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "TX",
            "license": "V6040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jacqueline F Keish, PH.D
• Keller Premier Anesthesia, PLLC
• Justin Keller, PT, MPT, OCS, CSCS
• Rebecca Leeanne Kellogg, AU.D.
• Kelly Cheatham Counseling
• Madison Alysse Kemp, PMHNP-BC
• Kendall Care, LLC
• Keri Kay Kendall, PMHNP
• Michiel Judson Kendall, D.C.
• Pamela Rachele Kendall, D.C.

• Plastic and Reconstructive Surgery Physician in Southlake, TX
• Providers in Southlake, TX by specialty
• Plastic and Reconstructive Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2025; 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.