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Individual

DR. KEITH CLEMENTS WARREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PH D

Contact information

Practice address
5020 LAKELAND CIR, SUITE B, WACO, TX 76710-2996
(254) 722-9961
(254) 399-9290
Mailing address
5020 LAKELAND CIR, SUITE B, WACO, TX 76710-2996
(254) 722-9961
(254) 399-9290

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
23289
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00D59R
BCBS
TX
05
039240902
TX
Enumeration date
10/27/2006
Last updated
05/02/2014
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