Provider Demographics
NPI:1417034570
Name:RICHARD R. KEENE MD PA
Entity Type:Organization
Organization Name:RICHARD R. KEENE MD PA
Other - Org Name:PROFESSIONAL PATHOLOGY/O2 TESTING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:R
Authorized Official - Last Name:KEENE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-241-8060
Mailing Address - Street 1:PO BOX 866815
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75086-6815
Mailing Address - Country:US
Mailing Address - Phone:888-986-4001
Mailing Address - Fax:888-986-4010
Practice Address - Street 1:3605 CLAYMORE DR
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-6206
Practice Address - Country:US
Practice Address - Phone:888-986-4001
Practice Address - Fax:888-986-4010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9263207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTB05OtherBLUE CROSS BLUE SHIELD
TXTB05OtherBLUE CROSS BLUE SHIELD
TX00LK25Medicare PIN