Provider Demographics
NPI:1891438164
Name:RASIC, KEATON (MD)
Entity Type:Individual
Prefix:
First Name:KEATON
Middle Name:
Last Name:RASIC
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 1:26637 WHITE SPRUCE DR
Mailing Address - Street 2:
Mailing Address - City:EAGLE RIVER
Mailing Address - State:AK
Mailing Address - Zip Code:99577-9673
Mailing Address - Country:US
Mailing Address - Phone:907-351-8782
Mailing Address - Fax:
Practice Address - Street 1:UT HEALTH SCIENCE CENTER AT SAN ANTONIO
Practice Address - Street 2:
Practice Address - City:7703 FLOYD CURL DR
Practice Address - State:TX
Practice Address - Zip Code:78229
Practice Address - Country:US
Practice Address - Phone:210-567-7000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-15
Last Update Date:2022-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program