Keller, Charles W
Keller, Charles W is an sole proprietor health care provider with primary practice located at 5502 58Th St Suite 600, Lubbock TX 79414-2000. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Keller, Charles W can be contacted via phone (806) 792-4713.Contact Information
Primary practice address
5502 58Th St Suite 600
Lubbock TX 79414-2000
Phone: (806) 792-4713
Fax: (806) 792-1506
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 2-0861 | Texas |
Profile Details
NPI number | 1417921693 |
---|---|
LBN Legal business name | Keller, Charles W |
Credentials | PH.D. |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Feb 15th, 2006 |
Last updated | Jan 4th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1417921693 | NPPES |
Texas | MEDICAID | 035131401 |
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