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NPI Code Detail

MEDICARE: JAMES KEITH CRNA

MEDICARE: JAMES KEITH CRNA
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
1367500000XCertified Registered Nurse Anesthetist13043TN

General Provider Information

NPI Number : 1750563797
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES KEITH CRNA
Provider Business Mailing Address
First Line : PO BOX 845347
Second Line :
City : DALLAS
State : TX
Zip : 75284-5347
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 5323 HARRY HINES BLVD
Second Line :
City : DALLAS
State : TX
Zip : 75390-7201
Country : US
Telephone Number : 214-645-0355
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2007
Last Update Date : 02/26/2026

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