Individual
KEVIN THOMAS MCLEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1303 MARLSTONE DR, HOUSTON, TX 77094-3081
(832) 623-4264
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
1235613464
FL
363AS0400X
Surgical Physician Assistant
Primary
PA.0007560
CO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/24/2018
Last updated
01/17/2023
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