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General NPI Number Information
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NPI Number | 1992771745
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Entity Type | Individual
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Provider Name | KEITH LEPAK MD
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Gender | Male
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 02/23/2015
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Provider Practice Location Address
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Address Line | 2700 E ELDORADO PKWY STE 104
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City | LITTLE ELM
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State | TX
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Zip | 75068-5999
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Country | US
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Telephone | 972-987-4935
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Fax | 972-987-4574
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Provider Business Mailing Address
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Address Line | 6501 PRESTON RD STE 102
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City | PLANO
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State | TX
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Zip | 75024-2610
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Country | US
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Telephone | 972-403-1155
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Fax | 972-608-0044
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | H9670
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License Number State | TX
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