Provider Demographics
NPI:1316337140
Name:KEENER, CARL R (PHD)
Entity type:Individual
Prefix:DR
First Name:CARL
Middle Name:R
Last Name:KEENER
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:15303 HUEBNER RD STE 11
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78248-0983
Mailing Address - Country:US
Mailing Address - Phone:210-227-1460
Mailing Address - Fax:210-227-1470
Practice Address - Street 1:15303 HUEBNER RD STE 11
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78248-0983
Practice Address - Country:US
Practice Address - Phone:210-227-1460
Practice Address - Fax:210-227-1470
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXMO04312085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology