MEDICARE: PATRICIA KEENE

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
1	183500000X	Pharmacist	38416	TX

General Provider Information

NPI Number	:	1164717971
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA KEENE

Provider Business Mailing Address
First Line	:	19511 INTERSTATE 45 N
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-6015
Country	:	US
Telephone Number	:	281-288-5018
Fax Number	:

Provider Business Practice Location Address
First Line	:	19511 INTERSTATE 45 N
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77388-6015
Country	:	US
Telephone Number	:	281-288-5018
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2011
Last Update Date	:	06/09/2011

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Directions to “ PATRICIA KEENE ” Practice Location

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