Provider Demographics
NPI:1730182601
Name:KEINARTH, PAUL D (MD)
Entity type:Individual
Prefix:DR
First Name:PAUL
Middle Name:D
Last Name:KEINARTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5222 BURNET RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756
Mailing Address - Country:US
Mailing Address - Phone:512-459-9889
Mailing Address - Fax:512-389-2935
Practice Address - Street 1:5222 BURNET RD
Practice Address - Street 2:STE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-2433
Practice Address - Country:US
Practice Address - Phone:512-459-9889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4454207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX60069673OtherDPS NUMBER
TXH4454OtherLICENSE NUMBER
TXBK1498042OtherDEA NUMBER
TX60069673OtherDPS NUMBER
TXBK1498042OtherDEA NUMBER