Provider Demographics
NPI:1588860167
Name:KEGLOVITS, LATOYA GUINN (MD)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:GUINN
Last Name:KEGLOVITS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3600 GASTON AVE
Mailing Address - Street 2:SUITE 261
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-1800
Mailing Address - Country:US
Mailing Address - Phone:972-966-7871
Mailing Address - Fax:972-966-7899
Practice Address - Street 1:2501 SOUTH STATE HWY 121
Practice Address - Street 2:SUITE 1210
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8188
Practice Address - Country:US
Practice Address - Phone:972-966-7871
Practice Address - Fax:972-966-7899
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP0613207ZP0102X
VA0101253100207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology