Individual
DR. KEITH MICHAEL CAVANESS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3410 WORTH ST, SUITE 235, DALLAS, TX 75246-2003
(214) 820-2302
(214) 820-2303
Mailing address
3410 WORTH ST, SUITE 235, DALLAS, TX 75246-2003
(214) 820-2302
(214) 820-2303
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
5101016193
MI
208600000X
Surgery Physician
Primary
P0018
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
285991001
—
TX
01
—
8CZ261
BCBSTX
TX
Enumeration date
04/04/2007
Last updated
01/16/2012
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