Individual
DR. KEITH ELLIOTT DYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7200 W 9TH AVE, AMARILLO, TX 79106-1703
(806) 416-1041
(806) 418-4329
Mailing address
PO BOX 51199, AMARILLO, TX 79159-1199
(806) 416-1041
(806) 418-4329
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
K5914
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0052HZ
BC/BS GROUP NUMBER
TX
01
—
112061103
FIRSTCARE PROV NUMBER
—
01
—
8G3990
BC/BS INDIVIDUAL NUMBER
TX
Enumeration date
07/27/2006
Last updated
10/07/2014
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