Provider Demographics
NPI:1588821565
Name:KEELING-JOHNSON, KONYA K (MD)
Entity Type:Individual
Prefix:DR
First Name:KONYA
Middle Name:K
Last Name:KEELING-JOHNSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:KONYA
Other - Middle Name:K
Other - Last Name:KEELING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1400 CREEK WAY DR
Mailing Address - Street 2:100
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4072
Mailing Address - Country:US
Mailing Address - Phone:832-582-7708
Mailing Address - Fax:
Practice Address - Street 1:1400 CREEK WAY DR
Practice Address - Street 2:100
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4072
Practice Address - Country:US
Practice Address - Phone:832-582-7708
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-19
Last Update Date:2014-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP2469208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery