Provider Demographics
NPI:1912180597
Name:KEITH L. MARKEY MD PA
Entity Type:Organization
Organization Name:KEITH L. MARKEY MD PA
Other - Org Name:ADVANCED SPORTS MEDICINE & ORTHOPAEDICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MARKEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-639-3900
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-06
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1136207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117101905Medicaid
TX=========OtherTIN
TX117101905Medicaid
TX8086N1Medicare UPIN