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Organization
KEITH S. LIVINGSTONE M D P A
Active
Organization
KEITH S. LIVINGSTONE M D P A
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEITH SHILLING LIVINGSTONE MD (OWNER)
(817) 294-5600
Entity
Organization
Contact information
Practice address
6601 DAN DANCIGER RD, SUITE 200, FORT WORTH, TX 76133
(817) 294-5600
(817) 263-7234
Mailing address
6601 DAN DANCIGER RD, SUITE 200, FORT WORTH, TX 76133
(817) 294-5600
(817) 263-7234
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G5305
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114941103
—
TX
Enumeration date
08/29/2006
Last updated
12/10/2018
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