Individual provider · Type 1 NPI

Kevin P. Scully, PAC

Physician Assistant · Tyler, TX

NPI number 1730199563 Active

Practice location

2210 Three Lakes Pkwy Ste 100
Tyler, TX 75703-0642

Call (903) 747-4050 Map

Fax (903) 747-4075

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XPA03374 (TX)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1730199563

Kevin P. Scully, PAC's National Provider Identifier is 1730199563, issued on Aug 8, 2006. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Tyler, TX. The record was last updated on Feb 5, 2026.