Healthcare Provider Details

I. General information

NPI: 1457981359
Provider Name (Legal Business Name): KEITH ARRANTS REEGT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2020
Last Update Date: 01/19/2020
Certification Date: 01/19/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2012 JUSTIN RD STE 200-H
HIGHLAND VILLAGE TX
75077-7193
US

IV. Provider business mailing address

2012 JUSTIN RD STE 200-H
HIGHLAND VILLAGE TX
75077-7193
US

V. Phone/Fax

Practice location:
  • Phone: 877-944-2111
  • Fax: 877-492-1768
Mailing address:
  • Phone: 877-944-2111
  • Fax: 877-492-1768

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: