Individual
MR. KEITH LOYD COPELAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
4120 SOUTHWEST FWY, SUITE 100, HOUSTON, TX 77027-7339
(713) 626-8500
(713) 626-8560
Mailing address
PO BOX 4346, DEPT 398, HOUSTON, TX 77210-4346
(281) 358-8114
(281) 358-0609
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
236533
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
031051
RECERTIFICATION AANA
TX
01
—
031051
CRNA
—
05
—
1501417
—
LA
01
—
81740U
BLUE CROSS BLUE SHIELD
TX
01
—
86923U
BLUE CROSS BLUE SHIELD
TX
01
—
P00379468
RAILROAD MEDICARE
TX
Enumeration date
09/13/2005
Last updated
02/27/2008
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