Kevin P Scully, PAC

NPI #1730199563 in Tyler, Texas

Provider Information

NPI Number: 1730199563
Entity Type: Individual
Name: Kevin P Scully, PAC
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PAC
Enumeration Date: Aug 8, 2006
Last Updated: Feb 5, 2026

Practice Location

Address: 2210 THREE LAKES PKWY STE 100
City: Tyler
State: Texas
ZIP Code: 75703-0642
Phone: (903) 747-4050

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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