Provider Demographics
NPI:1689925638
Name:LEE KEENEN DPM PLLC
Entity Type:Organization
Organization Name:LEE KEENEN DPM PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEE
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:KEENEN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DPM
Authorized Official - Phone:210-865-2737
Mailing Address - Street 1:PO BOX 1328
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78841-1328
Mailing Address - Country:US
Mailing Address - Phone:210-865-2737
Mailing Address - Fax:
Practice Address - Street 1:1162 E SONTERRA BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4047
Practice Address - Country:US
Practice Address - Phone:210-865-2737
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-29
Last Update Date:2013-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1925213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty