Provider Demographics
NPI:1407901721
Name:KEITH HUYNH MD PA
Entity type:Organization
Organization Name:KEITH HUYNH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:ANH
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-469-3221
Mailing Address - Street 1:21216 NORTHWEST FWY
Mailing Address - Street 2:SUITE 260
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429
Mailing Address - Country:US
Mailing Address - Phone:281-469-3221
Mailing Address - Fax:281-970-6577
Practice Address - Street 1:21216 NORTHWEST FWY
Practice Address - Street 2:SUITE 260
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4695
Practice Address - Country:US
Practice Address - Phone:281-469-3221
Practice Address - Fax:281-970-6577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5997207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122019601Medicaid
TX0033CFOtherBLUECROSS BLUESHIELD
TXTXB104320Medicare PIN
TX122019601Medicaid