Individual
MR. KEITH GIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4519 N GARFIELD ST STE 15, MIDLAND, TX 79705-3400
(432) 699-0225
Mailing address
PO BOX 4157, MIDLAND, TX 79704-4157
(432) 699-0225
Taxonomy
Speciality
Code
Description
License number
State
163WP0000X
Pain Management Registered Nurse
102120
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
758719
TX
Other
Enumeration date
03/18/2014
Last updated
10/24/2024
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