Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Kelly Ingrid Sullivan, MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1043492291

Dr. Kelly Ingrid Sullivan, MD is a Student in an Organized Health Care Education/Training Program in College Station, Texas. Licensed in Texas. Registered with an NPI since 2007.

Licensed in
TX
In the registry since
2007
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1602 Rock Prairie Rd Ste 340
College Station, TX 77845-8306
Phone: (979) 696-4440
Fax: (979) 696-7812
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence N1166 (TX)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1043492291
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 29, 2007
Last updated in NPPESMay 21, 2010

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