Provider Demographics
NPI:1780740019
Name:CATHEY, GEORGE KEITH (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:KEITH
Last Name:CATHEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6609 BLANCO RD STE 215
Mailing Address - Street 2:SUITE 215
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-6177
Mailing Address - Country:US
Mailing Address - Phone:210-340-0781
Mailing Address - Fax:
Practice Address - Street 1:6609 BLANCO RD
Practice Address - Street 2:SUITE 215
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78216-6264
Practice Address - Country:US
Practice Address - Phone:210-340-0781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD107841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7389680001Medicare NSC