Provider Demographics
NPI:1528192549
Name:KEELER, KAREN DIANE (PT)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:DIANE
Last Name:KEELER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5410 FREDERICKSBURG RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3554
Mailing Address - Country:US
Mailing Address - Phone:210-541-0058
Mailing Address - Fax:210-541-0058
Practice Address - Street 1:5410 FREDERICKSBURG RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3554
Practice Address - Country:US
Practice Address - Phone:210-541-0058
Practice Address - Fax:210-541-0058
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2013-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1162820225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist