Provider Demographics
NPI:1265417315
Name:KEELAND, RUTH KIMBERLY (MD)
Entity type:Individual
Prefix:DR
First Name:RUTH
Middle Name:KIMBERLY
Last Name:KEELAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:R
Other - Middle Name:KIMBERLY
Other - Last Name:KEELAND
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5717 BALCONES DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4203
Mailing Address - Country:US
Mailing Address - Phone:512-327-7000
Mailing Address - Fax:512-314-1660
Practice Address - Street 1:1700 S MOPAC EXPY
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-327-7000
Practice Address - Fax:512-314-1660
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3512207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10011897OtherAMERIGROUP
TX571561OtherAFFILIATED HEALTHCARE
TX41228OtherCOLE VISION
NY55343-009OtherDAVIS VISION
OHTX3512OtherEYEMED
TX85027KMedicare PIN
TX918291OtherBLOCK VISION
132759100OtherFIRST CARE
TX80367SOtherBLUE CROSS BLUE SHIELD
TX123762005Medicaid
SC180042764Medicare PIN
VP12818OtherGE WELLNESS
NY32951-021OtherDAVIS VISION
TX5019683OtherAETNA
TX2223881OtherBLUELINK
B23881Medicare UPIN