Individual
BONITA KEELING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.P.T.. PCS
Contact information
Practice address
3310 S BROADWAY AVE STE 100I, TYLER, TX 75701-7818
(903) 781-1832
(877) 798-4959
Mailing address
19142 BIG TIMBER RD, TYLER, TX 75703-8610
(903) 780-3505
(877) 798-4959
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1122315
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36621603
—
TX
05
—
366216502
—
TX
01
—
84132T, 63657
BCBS PAR, BCBS BLUE LINK
TX
Enumeration date
11/10/2006
Last updated
05/15/2026
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