Healthcare Provider Details

I. General information

NPI: 1861684441
Provider Name (Legal Business Name): MARK R KEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/16/2007
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5512 114TH ST
LUBBOCK TX
79424-2177
US

IV. Provider business mailing address

5512 114TH ST
LUBBOCK TX
79424-2177
US

V. Phone/Fax

Practice location:
  • Phone: 806-288-1075
  • Fax:
Mailing address:
  • Phone: 806-288-1075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberN1362
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: