Provider Demographics
NPI:1598070088
Name:HARRIGAN, KEITH PATRICK (PD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:PATRICK
Last Name:HARRIGAN
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6540 VANDERBILT AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75214-3421
Mailing Address - Country:US
Mailing Address - Phone:214-826-5650
Mailing Address - Fax:845-483-1735
Practice Address - Street 1:6540 VANDERBILT AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75214-3421
Practice Address - Country:US
Practice Address - Phone:214-826-5650
Practice Address - Fax:845-483-1735
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX019434183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist