Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | H2741 | TX |
Y | 207RI0011X | Interventional Cardiology | H2741 | TX |
NPI | 1053375550 |
---|---|
Provider Name | Dr. L Keith Routh |
First Address | Garland, TX 75044-2208 |
Second Address | Garland, TX 75044-2208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/04/2006 |
Last Update Date | 06/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
133781804 | (05) | TX |
E08190 | (02) | TX |