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General NPI Number Information
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NPI Number | 1285804971
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Entity Type | Individual
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Provider Name | BRENT KEITH MD
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Gender | Male
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Dates
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Enumeration Date | 03/10/2008
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 7211 PRESTON RD STE 3500
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City | PLANO
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State | TX
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Zip | 75024-0259
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Country | US
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Telephone | 469-344-7667
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Fax | 469-713-8037
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Provider Business Mailing Address
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Address Line | PO BOX 35629
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City | DALLAS
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State | TX
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Zip | 75235-0629
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Country | US
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Telephone | 214-424-2200
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Fax | 214-231-2159
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0206X
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Taxonomy Name | Pediatric Gastroenterology Physician
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License Number | GETP.LSU.G02053.F-G
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License Number State | LA
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