Healthcare Provider Details
I. General information
NPI: 1063530103
Provider Name (Legal Business Name): DR RICHARD KEH PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/27/2007
Last Update Date: 03/01/2021
Certification Date: 03/01/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
311 CAMDEN ST STE 309
SAN ANTONIO TX
78215-2013
US
IV. Provider business mailing address
311 CAMDEN ST STE 309
SAN ANTONIO TX
78215-2013
US
V. Phone/Fax
- Phone: 210-225-8822
- Fax: 210-225-8987
- Phone: 210-225-8822
- Fax: 210-225-8987
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207W00000X |
| Taxonomy | Ophthalmology Physician |
| License Number | J9400 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | 1137 |
| License Number State | TX |
VIII. Authorized Official
Name:
RICHARD
A
KEH
Title or Position: PRESIDENT
Credential: DPM
Phone: 210-225-8882