Provider Demographics
NPI:1053594226
Name:KEEN, STEVEN
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:
Last Name:KEEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2715 SAM BASS RD
Mailing Address - Street 2:SUITE 561
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-1811
Mailing Address - Country:US
Mailing Address - Phone:512-255-3010
Mailing Address - Fax:512-238-9522
Practice Address - Street 1:2715 SAM BASS RD
Practice Address - Street 2:SUITE 561
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78681-1811
Practice Address - Country:US
Practice Address - Phone:512-255-3010
Practice Address - Fax:512-238-9522
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2007-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX5820100001Medicare NSC