MEDICARE: ALEXIS KEENAN DO

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	208100000X	Physical Medicine & Rehabilitation Physician	032.0134300	VT
2	208100000X	Physical Medicine & Rehabilitation Physician	V4393	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DO2025-0200	OTHER	NM	LICENSE
2	V4393	OTHER	TX	TEXAS MEDICAL BOARD

General Provider Information

NPI Number	:	1811514128
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIS KEENAN DO

Provider Business Mailing Address
First Line	:	111 COLCHESTER AVE
Second Line	:
City	:	BURLINGTON
State	:	VT
Zip	:	05401-1473
Country	:	US
Telephone Number	:	802-847-0000
Fax Number	:

Provider Business Practice Location Address
First Line	:	6955 N MESA ST STE 200
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912-4424
Country	:	US
Telephone Number	:	833-339-7246
Fax Number	:

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

Provider Enumeration Date	:	07/02/2020
Last Update Date	:	01/21/2026

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