Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Kelly John Skipper, SURGICALASSISTANT

Individual provider Surgical Physician Assistant · NPI 1154654507

Mr. Kelly John Skipper, SURGICALASSISTANT is a Surgical Physician Assistant in Dallas, Texas. Practices as a sole proprietor. Licensed in Texas.

Licensed in
TX
In the registry since
2009

Practice location Address checks out

4525 Gilbert Ave #107
Dallas, TX 75219-2122
Phone: (214) 529-5024
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence 09-262 (TX)

Record details

NPI number1154654507
Entity typeIndividual (Type 1)
GenderMale
Credentials SURGICALASSISTANT
Sole proprietorYes
NPI enumeratedSeptember 16, 2009
Last updated in NPPESSeptember 16, 2009

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