Basic Information
| Provider Information | |||||||||
| NPI: | 1275065682 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KEE | ||||||||
| FirstName: | CLARENCE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1601 TRINITY ST STOP Z0200 | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787121850 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8338822737 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1601 TRINITY ST | ||||||||
| Address2: | |||||||||
| City: | AUSTIN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 787121765 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8338822737 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/03/2017 | ||||||||
| LastUpdateDate: | 08/30/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/30/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207X00000X | T6277 | TX | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.