Individual
DR. KEELI L STUMBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1201 HEWITT DR STE 105B, WACO, TX 76712-8833
(254) 230-4225
Mailing address
1201 HEWITT DR STE 105B, WACO, TX 76712-8833
(254) 230-4225
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
L1469
TX
208VP0000X
Pain Medicine Physician
L1469
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140921106
—
TX
Enumeration date
06/17/2005
Last updated
03/01/2022
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