Basic Information
| Provider Information | |||||||||
| NPI: | 1427319979 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MASSEY | ||||||||
| FirstName: | KEEGAN | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2601 HOSPITAL BLVD | ||||||||
| Address2: | SUITE 117 | ||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784051815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3619024789 | ||||||||
| FaxNumber: | 3619024588 | ||||||||
| Practice Location | |||||||||
| Address1: | 2601 HOSPITAL BLVD | ||||||||
| Address2: | SUITE 117 | ||||||||
| City: | CORPUS CHRISTI | ||||||||
| State: | TX | ||||||||
| PostalCode: | 784051815 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3619024789 | ||||||||
| FaxNumber: | 3619024588 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2012 | ||||||||
| LastUpdateDate: | 08/04/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | Q2799 | TX | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.