Healthcare Provider Details

I. General information

NPI: 1265627038
Provider Name (Legal Business Name): CHRISTI L KEELER MS, ATC, LAT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/13/2007
Last Update Date: 01/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 DUBLIN DR
LEAGUE CITY TX
77573-4955
US

IV. Provider business mailing address

2211 DUBLIN DR
LEAGUE CITY TX
77573-4955
US

V. Phone/Fax

Practice location:
  • Phone: 832-425-0218
  • Fax:
Mailing address:
  • Phone: 832-425-0218
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number0126001040
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT4444
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number060602247
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: