| Keith S. Livingstone M D P A | |
|
6601 Dan Danciger Rd Suite 200 Fort Worth TX 76133 | |
| (817) 294-5600 | |
| (817) 263-7234 |
| Full Name | Keith S. Livingstone M D P A |
|---|---|
| Speciality | Family Medicine |
| Location | 6601 Dan Danciger Rd, Fort Worth, Texas |
| Authorized Official Name and Position | Keith Shilling Livingstone (OWNER) |
| Authorized Official Contact | 8172945600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keith S. Livingstone M D P A 6601 Dan Danciger Rd Suite 200 Fort Worth TX 76133 Ph: (817) 294-5600 | Keith S. Livingstone M D P A 6601 Dan Danciger Rd Suite 200 Fort Worth TX 76133 Ph: (817) 294-5600 |
| NPI Number | 1639287451 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 12/10/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639287451 | NPI | - | NPPES |
| 114941103 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | G5305 (Texas) | Primary |
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