Provider Demographics
NPI:1033640917
Name:BESS, KEITH
Entity type:Individual
Prefix:
First Name:KEITH
Middle Name:
Last Name:BESS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 S MARTIN LUTHER KING ST
Mailing Address - Street 2:
Mailing Address - City:SWEENY
Mailing Address - State:TX
Mailing Address - Zip Code:77480-2908
Mailing Address - Country:US
Mailing Address - Phone:979-417-8501
Mailing Address - Fax:
Practice Address - Street 1:204 S MARTIN LUTHER KING ST
Practice Address - Street 2:
Practice Address - City:SWEENY
Practice Address - State:TX
Practice Address - Zip Code:77480-2908
Practice Address - Country:US
Practice Address - Phone:979-417-8501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-23
Last Update Date:2017-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCOT010001245225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist