Provider Demographics
NPI:1407839434
Name:KEEFE, CARMEN KAY (PHD)
Entity Type:Individual
Prefix:DR
First Name:CARMEN
Middle Name:KAY
Last Name:KEEFE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16990 DALLAS PKWY
Mailing Address - Street 2:SUITE #255
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-1926
Mailing Address - Country:US
Mailing Address - Phone:972-233-6575
Mailing Address - Fax:972-407-0213
Practice Address - Street 1:16990 DALLAS PKWY
Practice Address - Street 2:SUITE #255
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-1926
Practice Address - Country:US
Practice Address - Phone:972-233-6575
Practice Address - Fax:972-407-0213
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2-4423103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00H89RMedicare ID - Type UnspecifiedID NUMBER