MEDICARE: DR. WILLIAM GREGORY KEILIN PH.D.

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	103T00000X	Psychologist	24176	TX

General Provider Information

NPI Number	:	1326041120
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM GREGORY KEILIN PH.D.

Provider Business Mailing Address
First Line	:	3355 BEE CAVES RD
Second Line	:	STE 104
City	:	AUSTIN
State	:	TX
Zip	:	78746-6673
Country	:	US
Telephone Number	:	512-327-6441
Fax Number	:

Provider Business Practice Location Address
First Line	:	3355 BEE CAVES RD
Second Line	:	STE 104
City	:	AUSTIN
State	:	TX
Zip	:	78746-6673
Country	:	US
Telephone Number	:	512-327-6441
Fax Number	:

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

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/08/2007

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