Bourgeois, Keith Alan

Bourgeois, Keith Alan is an individual health care provider with primary practice located at 1315 St Joseph Pkwy Suite 1601, Houston TX 77002-8233. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Bourgeois, Keith Alan can be contacted via phone (713) 650-0391.

Contact Information

Primary practice address
1315 St Joseph Pkwy Suite 1601 Houston TX 77002-8233
Phone: (713) 650-0391
Fax: (713) 650-0395
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X G7625 Texas

Profile Details

NPI number 1457312183
LBN Legal business name Bourgeois, Keith Alan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 31st, 2006
Last updated Jan 25th, 2012 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1457312183 NPPES
Texas MEDICAID P085170J07

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