Provider Demographics
NPI:1275961583
Name:DOBBS, KAILEY RENE (PA-C)
Entity Type:Individual
Prefix:
First Name:KAILEY
Middle Name:RENE
Last Name:DOBBS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:KAILEY
Other - Middle Name:RENE
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:800 MEDICAL CENTER DR STE C
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:TX
Mailing Address - Zip Code:76234-3844
Mailing Address - Country:US
Mailing Address - Phone:940-626-2110
Mailing Address - Fax:940-626-2113
Practice Address - Street 1:800 MEDICAL CENTER DR STE C
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3844
Practice Address - Country:US
Practice Address - Phone:940-626-2110
Practice Address - Fax:940-626-2113
Is Sole Proprietor?:No
Enumeration Date:2013-10-23
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant