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Individual
KEVIN SKINNER
Active
Individual
KEVIN SKINNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA07717
TX
363A00000X
Physician Assistant
Primary
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
288707703
—
TX
05
—
288707704
—
TX
05
—
288707705
—
TX
05
—
288707706
—
TX
05
—
288707707
—
TX
01
—
75-0818167-015
TRICARE
TX
01
—
75-0818167-022
TRICARE
TX
01
—
75-0818167-044
TRICARE
TX
01
—
75-0818167-048
TRICARE
TX
01
—
75-1976930-005
TRICARE
TX
01
—
75-2616977-001
TRICARE
TX
01
—
75-2616977-002
TRICARE
TX
01
—
75-2616977-028
TRICARE
TX
01
—
75-2616977-129
TRICARE
TX
01
—
8107ND
BCBS
TX
01
—
8108ND
BCBS
TX
01
—
8808NA
BCBS
TX
01
—
P01200590
RAIL ROAD
TX
01
—
P01200614
RAIL ROAD
TX
01
—
P01276462
RAIL ROAD
TX
Enumeration date
12/09/2011
Last updated
11/14/2022
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