Active NPI
Gary Don Keel, PA-C
- Medical Physician Assistant
- Ft. Worth, TX
National Provider Identifier
1801036868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- PA02112
- Practice address
- #1 Lockheed Blvd.
Lockheed Martin Aeronautics Company
Ft. Worth, TX 76108 - Phone
- (817) 777-8183
- Fax
- (817) 777-1956
- NPI assigned
- Mar 3, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | PA02112 | TX | Primary |
Addresses
Primary practice location
#1 Lockheed Blvd.
Lockheed Martin Aeronautics Company
Ft. Worth, TX 76108
Mailing address
3106 Walnut Creek Pkwy
Granbury, TX 76049-7916
Phone (817) 326-5586
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA02112 | TX | MD | Medical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1236038400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1236124800000",
"number": "1801036868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3106 WALNUT CREEK PKWY",
"city": "GRANBURY",
"state": "TX",
"postal_code": "760497916",
"telephone_number": "817-326-5586"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "#1 LOCKHEED BLVD.",
"address_2": "LOCKHEED MARTIN AERONAUTICS COMPANY",
"city": "FT. WORTH",
"state": "TX",
"postal_code": "76108",
"telephone_number": "817-777-8183",
"fax_number": "817-777-1956"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEEL",
"first_name": "GARY",
"middle_name": "DON",
"name_prefix": "Mr.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-03-03",
"last_updated": "2009-03-04",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "TX",
"license": "PA02112",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ft. Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.