Garoutte, Keila Michele
Garoutte, Keila Michele is an individual health care provider with primary practice located at 815 Pennsylvania Ave , Fort Worth TX 76104-2224. She recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as her primary health care specialty. Garoutte, Keila Michele can be contacted via phone (817) 321-0387.Contact Information
Primary practice address
815 Pennsylvania Ave
Fort Worth TX 76104-2224
Phone: (817) 321-0387
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | K3190 | Texas |
Profile Details
| NPI number | 1063411932 |
|---|---|
| LBN Legal business name | Garoutte, Keila Michele |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2005 |
| Last updated | Dec 20th, 2018 - about 8 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 | 1063411932 | NPPES |
| Texas | MEDICAID | 1687113-06 | |
| Texas | MEDICAID | 168711301 | |
| Texas | MEDICAID | 168711302 |
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