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NPI Code Detail

MEDICARE: KATHERINE KEELAN RD, LD

MEDICARE: KATHERINE KEELAN RD, LD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianDT93156TX

General Provider Information

NPI Number : 1073440269
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE KEELAN RD, LD
Provider Business Mailing Address
First Line : 17060 DALLAS PKWY STE 112
Second Line :
City : DALLAS
State : TX
Zip : 75248-1905
Country : US
Telephone Number : 469-372-2022
Fax Number : 469-372-2022
Provider Business Practice Location Address
First Line : 17060 DALLAS PKWY STE 112
Second Line :
City : DALLAS
State : TX
Zip : 75248-1905
Country : US
Telephone Number : 469-372-2022
Fax Number : 469-372-2022
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/04/2026
Last Update Date : 05/04/2026

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Directions to “ KATHERINE KEELAN RD, LD” Practice Location

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