Organization
KELLER DERMATOLOGY, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK B COHEN D.O. (PRESIDENT)
(817) 753-6633
Entity
Organization
Contact information
Practice address
601 S MAIN ST, SUITE 115, KELLER, TX 76248-7029
(817) 753-6633
(817) 753-6634
Mailing address
601 S MAIN ST, SUITE 115, KELLER, TX 76248-7029
(817) 753-6633
(817) 753-6634
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
F6536
TX
Other
Enumeration date
06/13/2010
Last updated
06/13/2010
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