Provider Demographics
NPI:1508518424
Name:KEITH EL, TONYA MONICE (DR)
Entity Type:Individual
Prefix:
First Name:TONYA
Middle Name:MONICE
Last Name:KEITH EL
Suffix:
Gender:F
Credentials:DR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:461 MEADOW PLACE DR APT 3210
Mailing Address - Street 2:
Mailing Address - City:WILLOW PARK
Mailing Address - State:TX
Mailing Address - Zip Code:76087-6753
Mailing Address - Country:US
Mailing Address - Phone:843-731-0551
Mailing Address - Fax:
Practice Address - Street 1:461 MEADOW PLACE DR APT 3210
Practice Address - Street 2:
Practice Address - City:WILLOW PARK
Practice Address - State:TX
Practice Address - Zip Code:76087-6753
Practice Address - Country:US
Practice Address - Phone:843-731-0551
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-21
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCC4M9Z5D8246RP1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy