Provider Demographics
NPI:1972782217
Name:KEENE, RICHARD R (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:R
Last Name:KEENE
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:PO BOX 866815
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75086-6815
Mailing Address - Country:US
Mailing Address - Phone:469-241-8060
Mailing Address - Fax:469-241-8065
Practice Address - Street 1:3415 CUSTER RD
Practice Address - Street 2:#124
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75023-7554
Practice Address - Country:US
Practice Address - Phone:469-241-8060
Practice Address - Fax:469-241-8065
Is Sole Proprietor?:No
Enumeration Date:2007-11-02
Last Update Date:2008-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE77587207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX81P786Medicare PIN