Dr. Keith D Walvoord
Otolaryngologist (ENT Doctor)
3605 Executive Dr
San Angelo
, Texas 76904-6884
Dr. Keith D Walvoord
Otolaryngologist (ENT Doctor)
3605 Executive Dr
San Angelo
, Texas 76904-6884
(325) 949-9555
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About
Features
Specialties
- Otolaryngologist (ENT Doctor)
Languages spoken
- English
Location
First Address
- Dr. Keith D Walvoord
- 3605 Executive Dr
- San Angelo, TX
- Zip : 76904-6884
- Phone : (325) 949-9555
Second Address
- Dr. Keith D Walvoord
- 3605 Executive Dr
- San Angelo, TX
- Zip : 76904-6884
- Phone : (325) 224-5354
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207Y00000X | Otolaryngologist (ENT Doctor) | G3891 | TX |
National Provider Identifier
| NPI | 1013974583 |
|---|---|
| Provider Name | Dr. Keith D Walvoord |
| First Address | San Angelo, TX 76904-6884 |
| Second Address | San Angelo, TX 76904-6884 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/04/2006 |
| Last Update Date | 05/12/2018 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 114600303 | (05) | TX |
| 821834 | BLUECROSS/BLUE SHIELD TX (01) | TX |
| C86995 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.