Provider Demographics
NPI:1245339183
Name:MAY, KEVIN GLEN (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:GLEN
Last Name:MAY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:6723 HIGHLANDS CT
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-0584
Mailing Address - Country:US
Mailing Address - Phone:903-989-7129
Mailing Address - Fax:903-201-6788
Practice Address - Street 1:6723 HIGHLANDS CT
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-0584
Practice Address - Country:US
Practice Address - Phone:903-989-7129
Practice Address - Fax:903-201-6788
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2019-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG5346207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88732YOtherBCBS
C18982Medicare UPIN
C18982Medicare UPIN