Kelly Leigh Mack, PA-C

Physician assistant in Fulshear, Texas · NPI 1396813960

Kelly Mack is one of 6 physician assistants practicing in Fulshear, Texas. Kelly Mack practices with Elite Dermatology, PLLC.

Registry record (NPPES)

NPI
1396813960
Type
Type 1 · Individual
Primary taxonomy
Physician Assistant, Medical · 363AM0700X
Address on file
995 N. Prince Frederick Blvd
Prince Frederick, MD 20678
(410) 535-5855
Enumerated
Dec 1, 2006
Record last updated
Aug 13, 2019
License states listed
CA, TX

Medicare (CMS)

Enrollment
Medicare-enrolled in TX
Physician Assistant
Revalidation due
No date set by CMS

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  • Procedure volumes by CPT code
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  • Full enrollment history
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Practice locations

More physician assistants in Fulshear

Updated August 2026. Practice locations and specialty come from the CMS Doctors and Clinicians file, the registry record from NPPES, and enrollment from CMS Medicare enrollment files. NPI records are corrected at the source, through NPPES.