| Keith C. Warren, Ph.d., P.c. | |
|
5020 Lakeland Cir Suite B Waco TX 76710-2996 | |
| (254) 722-9961 | |
| (254) 399-9290 |
| Full Name | Keith C. Warren, Ph.d., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 5020 Lakeland Cir, Waco, Texas |
| Authorized Official Name and Position | Keith C. Warren (PRESIDENT) |
| Authorized Official Contact | 2547229961 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Keith C. Warren, Ph.d., P.c. 5020 Lakeland Cir Suite B Waco TX 76710-2996 Ph: (254) 722-9961 | Keith C. Warren, Ph.d., P.c. 5020 Lakeland Cir Suite B Waco TX 76710-2996 Ph: (254) 722-9961 |
| NPI Number | 1811178445 |
|---|---|
| Provider Enumeration Date | 11/26/2007 |
| Last Update Date | 11/26/2007 |
| Medicare PECOS PAC ID | 1052468378 |
|---|---|
| Medicare Enrollment ID | O20090402000306 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811178445 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103T00000X | Psychologist | 23289 (Texas) | Primary |
| Provider Name | Keith C Warren |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1649356031 PECOS PAC ID: 6305815119 Enrollment ID: I20040929000049 |
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