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Individual

KYLE KEYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
901 W 38TH ST STE 200, AUSTIN, TX 78705-1165
(512) 421-4235
(512) 454-4575
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-2987

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
BP10044571
TX
208800000X
Urology Physician
Primary
R1229
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
370874502
TX
05
370874503
TX
05
370874504
TX
Enumeration date
05/11/2012
Last updated
08/25/2021
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