Provider Demographics
NPI:1578564506
Name:FIMAN, KEITH H (MD)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:H
Last Name:FIMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1111 HIGHWAY 6
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4914
Mailing Address - Country:US
Mailing Address - Phone:281-491-9779
Mailing Address - Fax:281-491-3551
Practice Address - Street 1:1111 HIGHWAY 6
Practice Address - Street 2:SUITE 105
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4914
Practice Address - Country:US
Practice Address - Phone:281-491-9779
Practice Address - Fax:281-491-3551
Is Sole Proprietor?:No
Enumeration Date:2005-08-01
Last Update Date:2009-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH2370207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100017207OtherRAILROAD MEDICARE
TX131146608Medicaid
TX8F8812OtherBLUE CROSS BLUE SHIELD TX
TX8F8812OtherBLUE CROSS BLUE SHIELD TX
TX8477B2Medicare ID - Type UnspecifiedMEDICARE-FORT BEND COUNTY
TXE92895Medicare UPIN