MEDICARE: DR. KATHY LYNNE O'KEEFE D.D.S., M.S.

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	122300000X	Dentist	14795	TX

General Provider Information

NPI Number	:	1225050081
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHY LYNNE O'KEEFE D.D.S., M.S.

Provider Business Mailing Address
First Line	:	4607 MIMOSA DR
Second Line	:
City	:	BELLAIRE
State	:	TX
Zip	:	77401-5815
Country	:	US
Telephone Number	:	713-661-6134
Fax Number	:

Provider Business Practice Location Address
First Line	:	2518 DORRINGTON ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77030-1929
Country	:	US
Telephone Number	:	713-661-3583
Fax Number	:	713-218-0724

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

Provider Enumeration Date	:	07/24/2006
Last Update Date	:	07/08/2007

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