Provider Demographics
NPI:1922190933
Name:KEELER-BOYSEN, DIANE
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:KEELER-BOYSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4407 BEE CAVE RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6405
Mailing Address - Country:US
Mailing Address - Phone:512-732-0732
Mailing Address - Fax:512-732-0735
Practice Address - Street 1:4407 BEE CAVE RD
Practice Address - Street 2:SUITE 303
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6405
Practice Address - Country:US
Practice Address - Phone:512-732-0732
Practice Address - Fax:512-732-0735
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG5243207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology