Organization
KELLER PREMIER ANESTHESIA, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVERLY MILLER (CREDENTIALING SPECIALIST)
(210) 996-6363
Entity
Organization
Contact information
Practice address
1110 E STATE HIGHWAY 114 STE 150, SOUTHLAKE, TX 76092-5250
(210) 996-6363
Mailing address
1110 E STATE HIGHWAY 114 STE 200, SOUTHLAKE, TX 76092-5252
(210) 996-6363
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
—
—
Other
Enumeration date
12/04/2019
Last updated
08/10/2021
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