Provider Demographics
NPI:1265444681
Name:KHAUV, KEAK C (MD)
Entity Type:Individual
Prefix:DR
First Name:KEAK
Middle Name:C
Last Name:KHAUV
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 1:11212 MONTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-4241
Mailing Address - Country:US
Mailing Address - Phone:915-595-4300
Mailing Address - Fax:915-595-4301
Practice Address - Street 1:11212 MONTWOOD DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936
Practice Address - Country:US
Practice Address - Phone:915-595-4300
Practice Address - Fax:915-595-4301
Is Sole Proprietor?:No
Enumeration Date:2006-08-13
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8762207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX002475649001OtherUNITED HEALTH CARE
TX7239659OtherAETNA INS
TX9554971OtherCIGNA INS
TX177304603Medicaid
TX080535001Medicaid
TX7239659OtherAETNA INS
TX080535001Medicaid
TX9554971OtherCIGNA INS
TX177304601Medicaid
TX8G0861Medicare PIN