Healthcare Provider Details

I. General information

NPI: 1285094482
Provider Name (Legal Business Name): ANDREA N. KEITHLER D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANDREA DORE

II. Dates (important events)

Enumeration Date: 03/01/2016
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3551 ROGER BROOKE DR SAN ANTONIO MILITARY MEDICAL CENTER, MCHE-ZDM-M
JBSA FT SAM HOUSTON TX
78234-4504
US

IV. Provider business mailing address

3551 ROGER BROOKE DR
SAN ANTONIO TX
78234-4504
US

V. Phone/Fax

Practice location:
  • Phone: 210-292-5077
  • Fax: 210-292-7868
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberV8660
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: