Individual
MR. KEITH L. GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6606 LBJ FWY, STE 200, DALLAS, TX 75240-6533
(972) 715-5000
(972) 715-9976
Mailing address
PO BOX 650865, DALLAS, TX 75265-0865
(972) 715-5000
(972) 715-9976
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
501807
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
501807
TX
Other
Enumeration date
07/19/2006
Last updated
10/27/2015
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