Mckelva, Michael

Mckelva, Michael is an individual health care provider with primary practice located at 630 S Fleishel Ave , Tyler TX 75701-2041. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Mckelva, Michael can be contacted via phone (903) 606-5560.

Contact Information

Primary practice address
630 S Fleishel Ave Tyler TX 75701-2041
Phone: (903) 606-5560
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA11152 Texas

Profile Details

NPI number 1346771748
LBN Legal business name Mckelva, Michael
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2017
Last updated Mar 23rd, 2021 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346771748 NPPES
Texas MEDICAID 370509704

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