Provider Demographics
NPI:1790088508
Name:KEELEN, DAVID MARTIN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MARTIN
Last Name:KEELEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5575 WARREN PKWY STE 208
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-4063
Mailing Address - Country:US
Mailing Address - Phone:817-533-7080
Mailing Address - Fax:817-533-7082
Practice Address - Street 1:5575 WARREN PKWY STE 208
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-4063
Practice Address - Country:US
Practice Address - Phone:817-533-7080
Practice Address - Fax:817-533-7082
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBPI0031946207L00000X
TXP2699208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Single Specialty
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX752877778OtherTAX ID