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NPI Code Detail

MEDICARE: GENNEVESSE KEISER

MEDICARE: GENNEVESSE KEISER
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
1106S00000XBehavior TechnicianRBT-25-499556TX

General Provider Information

NPI Number : 1659230613
Entity Type Code : Individual
Provider Name (Legal Business Name) : GENNEVESSE KEISER
Provider Business Mailing Address
First Line : 2011 TEXOMA PKWY STE 20
Second Line :
City : SHERMAN
State : TX
Zip : 75090-2688
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2011 TEXOMA PKWY STE 20
Second Line :
City : SHERMAN
State : TX
Zip : 75090-2688
Country : US
Telephone Number : 903-500-2090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2026
Last Update Date : 01/16/2026

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Directions to “ GENNEVESSE KEISER ” Practice Location

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