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Individual
KEITH F DESONIER JR.
Active
Individual
KEITH F DESONIER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA06946
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218752801
—
TX
05
—
218752802
—
TX
05
—
218752803
—
TX
Enumeration date
10/07/2010
Last updated
06/09/2011
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