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Individual
DR. KEITH D WALVOORD
Active
Individual
DR. KEITH D WALVOORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
G3891
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114600303
—
TX
01
—
821834
BLUECROSS/BLUE SHIELD TX
TX
Enumeration date
04/28/2006
Last updated
12/05/2018
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