Individual
DEBORAH A KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
218 PARK ST, TRINIDAD, TX 75163-6060
(903) 778-2942
Mailing address
218 PARK ST, TRINIDAD, TX 75163-6060
(903) 778-2942
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1266-023
WI
363AM0700X
Medical Physician Assistant
Primary
PA08061
TX
Other
Enumeration date
05/05/2006
Last updated
11/05/2019
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