Provider Demographics
NPI:1174848907
Name:KEY, JOHN CALEB (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:CALEB
Last Name:KEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 WATER ST
Mailing Address - Street 2:STE D 200
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-2974
Mailing Address - Country:US
Mailing Address - Phone:830-896-5005
Mailing Address - Fax:830-896-4747
Practice Address - Street 1:1001 WATER ST STE D-200
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-3566
Practice Address - Country:US
Practice Address - Phone:830-896-5005
Practice Address - Fax:830-896-4747
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-05
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE6116208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC17837Medicare UPIN