Provider Demographics
NPI:1285804971
Name:KEITH, BRENT (MD)
Entity type:Individual
Prefix:
First Name:BRENT
Middle Name:
Last Name:KEITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:PO BOX 35629
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-0629
Mailing Address - Country:US
Mailing Address - Phone:214-424-2200
Mailing Address - Fax:214-231-2159
Practice Address - Street 1:7211 PRESTON RD STE 3500
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-0259
Practice Address - Country:US
Practice Address - Phone:469-344-7667
Practice Address - Fax:469-713-8037
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2024-10-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
LAGETP.LSU.G02053.F-G2080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology