Provider Demographics
NPI:1780710830
Name:KEITH, WILLIAM CHAD (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHAD
Last Name:KEITH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3107 S IH 35
Mailing Address - Street 2:SUITE 787
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664
Mailing Address - Country:US
Mailing Address - Phone:512-835-1846
Mailing Address - Fax:512-716-0384
Practice Address - Street 1:3107 S IH 35
Practice Address - Street 2:SUITE 787
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664
Practice Address - Country:US
Practice Address - Phone:512-835-1846
Practice Address - Fax:512-716-0384
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-25
Last Update Date:2008-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX8901111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0080HGOtherBCBS
TX8F2080OtherBCBS
TX0080HGOtherBCBS
TX8F2080OtherBCBS