Provider Demographics
NPI:1073779427
Name:MCLAIN, KAYE R (PA)
Entity Type:Individual
Prefix:
First Name:KAYE
Middle Name:R
Last Name:MCLAIN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4316 23RD ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1812
Mailing Address - Country:US
Mailing Address - Phone:806-701-5858
Mailing Address - Fax:806-701-5799
Practice Address - Street 1:4316 23RD ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1812
Practice Address - Country:US
Practice Address - Phone:806-701-5858
Practice Address - Fax:806-701-5799
Is Sole Proprietor?:No
Enumeration Date:2008-08-05
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA05887OtherLICENSE