Provider Demographics
NPI:1477764405
Name:KEYS, WARREN LEE JR (LSA, CSA, OPA-C)
Entity Type:Individual
Prefix:
First Name:WARREN
Middle Name:LEE
Last Name:KEYS
Suffix:JR
Gender:M
Credentials:LSA, CSA, OPA-C
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Mailing Address - Street 1:PO BOX 84577
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-0012
Mailing Address - Country:US
Mailing Address - Phone:281-830-4845
Mailing Address - Fax:713-436-1295
Practice Address - Street 1:19202 LAKE RIDGE DR
Practice Address - Street 2:
Practice Address - City:MANVEL
Practice Address - State:TX
Practice Address - Zip Code:77578-3858
Practice Address - Country:US
Practice Address - Phone:281-830-4845
Practice Address - Fax:832-547-2249
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2023-10-07
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical