Doctor profile · Federal record
Dr. Kelly Rayburn, PA-C
Surgical Physician Assistant · Jbsa Lackland, TX
- NPI 1548228398
- 20 yrs on file
- Female
- Group practice
- No sanctions
Practice & contact
Operates at 2 locations .
- Primary practice
-
1100 Wilford Hall Loop
Jbsa Lackland, TX 782365638
(210) 314-0779 - Additional location
-
12709 Toepperwein RD Ste 101
Live Oak, TX 782333259
(210) 477-5151
fax (210) 477-5152 - Mailing address
-
10922 Iron Spg
Helotes, TX 780234569
Credentials & registration
- NPI registered
- May 2006 — 20 yrs on file
- Profile last updated
- December 2, 2019
- Specialty taxonomy
- 363AS0400X — NUCC code
- State license (1)
- Texas #PA05332
- Medicaid
- TX #345120501
Federal sanctions & exclusions
No sanctions, exclusions or revocations on file
Checked against OIG LEIE on NPI 1548228398. Last verified May 11, 2026.Open Payments
Industry payments received
All-time total
$44
Transactions
2
Manufacturers
1
| Payer (manufacturer) | Industry | Txns | Amount |
|---|---|---|---|
| REVANCE THERAPEUTICS, INC. | 2 | $44.28 |
By nature of payment
Frequently asked questions
What is Dr. Kelly Rayburn's medical specialty?
Dr. Kelly Rayburn practices Surgical Physician Assistant in Jbsa Lackland, TX.
Where does Dr. Kelly Rayburn practice?
Dr. Kelly Rayburn practices at 1100 Wilford Hall Loop, Jbsa Lackland, TX 782365638. Office phone: 2103140779.
What is Dr. Kelly Rayburn's NPI?
Dr. Kelly Rayburn's National Provider Identifier (NPI) is 1548228398, issued by NPPES.