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General NPI Number Information
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NPI Number | 1558566786
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Entity Type | Organization
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Legal Business Name | KEITH E. MATHENY, M.D., PLLC
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Dates
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Enumeration Date | 06/18/2007
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Last Update Date | 09/11/2008
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Provider Practice Location Address
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Address Line | 8380 WARREN PARKWAY SUITE 504
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City | FRISCO
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State | TX
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Zip | 75034-4197
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Country | US
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Telephone | 972-596-4005
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Fax | 972-985-1253
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Provider Business Mailing Address
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Address Line | 8380 WARREN PARKWAY SUITE 504
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City | FRISCO
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State | TX
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Zip | 75034-4197
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Country | US
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Telephone | 972-596-4005
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Fax | 972-985-1253
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Authorized Official
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Title or Position | OWNER
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Name | KEITH E MATHENY
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Credential | M.D.
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Telephone | 972-596-4005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | L5828
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License Number State | TX
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