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PATRICK KEEHAN DO PA NPI 1811533805


NPI Information

NPI: 1811533805
Provider Name: PATRICK KEEHAN DO PA
Classification: Dermatology - 207N00000X
Entity Type: Organization

CLIA Number: 45D2182039

Address:
1111 5TH AVE
FORT WORTH, TX
ZIP 76104
Phone: (817) 769-3603
Get Directions

PATRICK KEEHAN DO PA is a dermatology in Fort Worth, TX. The provider is a dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. PATRICK KEEHAN DO PA NPI is 1811533805. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1111 5TH AVE
FORT WORTH, TX
ZIP 76104-302
Phone: (817) 769-3603
Fax: (817) 348-0113

The provider's authorized official is Patrick Keehan .
The authorized official title is Dermatologist and has the following contact phone number (415) 802-1310.

The CLIA number assigned to this NPI record is 45D2182039 - physician office with a certificate type of Certificate of Registration.

The enumeration date for this NPI number is 11/25/2019 and was last updated on 6/12/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207N00000XDermatologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11366773889MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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