Provider Demographics
NPI:1003375924
Name:FLOYD, KEVIN SCOTT (PA-C)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:SCOTT
Last Name:FLOYD
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:KEVIN
Other - Middle Name:S
Other - Last Name:FLOYD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA-C
Mailing Address - Street 1:14849 TED BANKS AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-3143
Mailing Address - Country:US
Mailing Address - Phone:915-588-6400
Mailing Address - Fax:
Practice Address - Street 1:21227 TORCH STREET
Practice Address - Street 2:
Practice Address - City:BIGGS FIELD
Practice Address - State:TX
Practice Address - Zip Code:79918
Practice Address - Country:US
Practice Address - Phone:915-742-4248
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-19
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant