MEDICARE: ANNA GRACE KEMP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA17561	TX

General Provider Information

NPI Number	:	1285303669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANNA GRACE KEMP

Provider Business Mailing Address
First Line	:	8820 SOUTHWESTERN BLVD APT 1309
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75206-2824
Country	:	US
Telephone Number	:	214-762-5633
Fax Number	:

Provider Business Practice Location Address
First Line	:	11970 N CENTRAL EXPY STE 210
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75243-3784
Country	:	US
Telephone Number	:	972-940-9500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/09/2021
Last Update Date	:	04/02/2026

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Directions to “ ANNA GRACE KEMP ” Practice Location

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