Provider Demographics
NPI:1083779805
Name:SHAUN HAMLETT KEEL PC
Entity Type:Organization
Organization Name:SHAUN HAMLETT KEEL PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAUN
Authorized Official - Middle Name:H
Authorized Official - Last Name:KEEL
Authorized Official - Suffix:
Authorized Official - Credentials:EDD
Authorized Official - Phone:806-792-3181
Mailing Address - Street 1:2402 52ND ST.
Mailing Address - Street 2:SUITE 6
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79412
Mailing Address - Country:US
Mailing Address - Phone:806-792-3181
Mailing Address - Fax:806-792-3182
Practice Address - Street 1:2402 52ND ST.
Practice Address - Street 2:SUITE 6
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412
Practice Address - Country:US
Practice Address - Phone:806-792-3181
Practice Address - Fax:806-792-3182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23761103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00787UMedicare ID - Type Unspecified