Provider Demographics
NPI:1407901721
Name:KEITH HUYNH MD PA
Entity Type:Organization
Organization Name:KEITH HUYNH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:ANH
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-469-3221
Mailing Address - Street 1:10720 FM 1960 RD W
Mailing Address - Street 2:SUITE B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-6312
Mailing Address - Country:US
Mailing Address - Phone:281-469-3221
Mailing Address - Fax:281-970-6577
Practice Address - Street 1:21212 NORTHWEST FWY
Practice Address - Street 2:SUITE 435
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-5884
Practice Address - Country:US
Practice Address - Phone:281-469-3221
Practice Address - Fax:281-970-6577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2022-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5997207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0033CFOtherBLUECROSS BLUESHIELD
TX122019601Medicaid
TXTXB104320Medicare PIN
TX122019601Medicaid