Search › Texas › 106S00000X
Staten Mckellum
NPI 1831917517 · on the registry since 2024 · sole proprietor
Practice
- Address
- 1100 Kingston Ct
Rockwall, TX 75032 - Phone
- (469) 458-9021
- Clinicians at this address
- 5
Registry record
- Primary taxonomy
- 106S00000X
106S00000X
- Licence states on file
- TX
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2024-10-01
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas