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NPI Code Detail

MEDICARE: RICHARD R. KEENE MD PA

MEDICARE: RICHARD R. KEENE MD PA
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
1207ZP0102XAnatomic Pathology & Clinical Pathology PhysicianE9263TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1TB05OTHERTXBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1417034570
Entity Type Code : Organization
Provider Name (Legal Business Name) : RICHARD R. KEENE MD PA
Provider Business Mailing Address
First Line : PO BOX 866815
Second Line :
City : PLANO
State : TX
Zip : 75086-6815
Country : US
Telephone Number : 888-986-4001
Fax Number : 888-986-4010
Provider Business Practice Location Address
First Line : 3605 CLAYMORE DR
Second Line :
City : PLANO
State : TX
Zip : 75075-6206
Country : US
Telephone Number : 888-986-4001
Fax Number : 888-986-4010
Authorized Official
Title or Position : PRESIDENT
Name : RICHARD R KEENE
Credential : MD
Telephone Number : 469-241-8060
Provider Enumeration Date : 11/01/2006
Last Update Date : 11/17/2010

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