Provider Demographics
NPI:1477711398
Name:STIRRUP, KEITH ROBERT (PHD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:ROBERT
Last Name:STIRRUP
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1408B STONE HOLLOW PLACE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339
Mailing Address - Country:US
Mailing Address - Phone:281-814-5007
Mailing Address - Fax:
Practice Address - Street 1:1408B STONE HOLLOW PLACE
Practice Address - Street 2:SUITE 400
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339
Practice Address - Country:US
Practice Address - Phone:281-814-5007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33644103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist