MEDICARE: DR. L KEITH ROUTH MD

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	207RC0000X	Cardiovascular Disease Physician	H2741	TX
2	207RI0011X	Interventional Cardiology Physician	H2741	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053375550
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. L KEITH ROUTH MD

Provider Business Mailing Address
First Line	:	7150 N PRESIDENT GEORGE BUSH HWY STE 206
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-2208
Country	:	US
Telephone Number	:	972-276-8994
Fax Number	:	844-292-1462

Provider Business Practice Location Address
First Line	:	7150 N PRESIDENT GEORGE BUSH HWY STE 206
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-2208
Country	:	US
Telephone Number	:	972-276-8994
Fax Number	:	844-292-1462

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

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	04/06/2021

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Directions to “ DR. L KEITH ROUTH MD” Practice Location

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