Healthcare Provider Details

I. General information

NPI: 1093710600
Provider Name (Legal Business Name): JOHN MCKEEVER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2005
Last Update Date: 11/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

613 ELIZABETH ST SUITE 804
CORPUS CHRISTI TX
78404-2220
US

IV. Provider business mailing address

919 HIDDEN RDG
IRVING TX
75038-3813
US

V. Phone/Fax

Practice location:
  • Phone: 361-881-3351
  • Fax: 361-861-9022
Mailing address:
  • Phone: 469-282-2711
  • Fax: 469-282-0996

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberD9850
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: