Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | E2789 | TX |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | E2789 | TX |
NPI | 1881699270 |
---|---|
Provider Name | Dr. Keith Andrew Picou |
First Address | Mcallen, TX 78503-1294 |
Second Address | Mcallen, TX 78503-1294 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2005 |
Last Update Date | 29/04/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
040010413 | RAILROAD MEDICARE (01) | TX |
116616 | SUPERIOR HEALTH PLANS (01) | TX |
119708100 | VALLEY HEALTH PLANS (01) | TX |
133101901 | (05) | TX |
133101905 | CIDC (01) | TX |
176590500 | WORKERS COMPENSATION (01) | TX |
86260Y | BC/BS OF TEXAS NUMBER (01) | TX |
B25503 | (02) | TX |