MEDICARE: MCKEEVER CLINIC PLLC

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	207X00000X	Orthopaedic Surgery Physician	D5437	TX

General Provider Information

NPI Number	:	1992004634
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MCKEEVER CLINIC PLLC

Provider Business Mailing Address
First Line	:	5420 DASHWOOD DR
Second Line	:	SUITE 304
City	:	HOUSTON
State	:	TX
Zip	:	77081-5357
Country	:	US
Telephone Number	:	281-833-3330
Fax Number	:	281-833-3323

Provider Business Practice Location Address
First Line	:	1160 BLALOCK RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-7421
Country	:	US
Telephone Number	:	713-461-5575
Fax Number	:	281-833-3323

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	DR. GRANT R MCKEEVER
Credential	:	MD
Telephone Number	:	713-461-5575

Provider Enumeration Date	:	03/21/2011
Last Update Date	:	04/07/2011

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