Provider Demographics
NPI:1629035720
Name:MARKEY, KEITH LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:KEITH
Middle Name:LEE
Last Name:MARKEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5685 ARROYO LUIS DR
Mailing Address - Street 2:
Mailing Address - City:BULVERDE
Mailing Address - State:TX
Mailing Address - Zip Code:78163-3173
Mailing Address - Country:US
Mailing Address - Phone:210-639-3900
Mailing Address - Fax:210-496-7746
Practice Address - Street 1:5685 ARROYO LUIS DR
Practice Address - Street 2:
Practice Address - City:BULVERDE
Practice Address - State:TX
Practice Address - Zip Code:78163-3173
Practice Address - Country:US
Practice Address - Phone:210-639-3900
Practice Address - Fax:210-496-7746
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2013-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1136207X00000X, 207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX742759428OtherTAX ID
TX117101905Medicaid
TXC18792Medicare UPIN
TX8086N1Medicare ID - Type Unspecified