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General NPI Number Information
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NPI Number | 1235721796
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Entity Type | Organization
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Legal Business Name | KEYSTONE NEUROCARE
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Dates
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Enumeration Date | 02/05/2021
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Last Update Date | 07/30/2022
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Provider Practice Location Address
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Address Line | 3413 SPECTRUM BLVD STE 100
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City | RICHARDSON
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State | TX
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Zip | 75082-9705
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Country | US
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Telephone | 469-616-1992
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Fax | 469-519-1877
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Provider Business Mailing Address
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Address Line | 5756 BERNAY LN
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City | PLANO
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State | TX
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Zip | 75024-2911
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Country | US
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Telephone | 469-616-1922
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Fax | 469-519-1877
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Authorized Official
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Title or Position | PHYSICIAN
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Name | YU ZHAO
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Credential | MD
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Telephone | 469-616-1922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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