Provider Demographics
NPI:1538147707
Name:KEOUGH, KAREN CECILIA (MD)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:CECILIA
Last Name:KEOUGH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:CECILIA
Other - Last Name:RICHARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7940 SHOAL CREEK BLVD STE 100
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-7589
Mailing Address - Country:US
Mailing Address - Phone:512-494-4000
Mailing Address - Fax:512-494-4024
Practice Address - Street 1:7940 SHOAL CREEK BLVD STE 100
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78757-7589
Practice Address - Country:US
Practice Address - Phone:512-494-4000
Practice Address - Fax:512-494-4024
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ99162084N0402X, 2084N0600X, 2084E0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084E0001XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyEpilepsy
No2084N0402XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology
No2084N0600XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyClinical Neurophysiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX096463703Medicaid
TXG33594Medicare UPIN
TX8G8066Medicare PIN
TX272391YN9DMedicare PIN