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Search › Texas › 207Q00000X

Keith Wixtrom, M.D

NPI 1639193246 · on the registry since 2006 · sole proprietor

Practice

Address
7916 S Broadway Ave
Tyler, TX 75703
Phone
(903) 266-5900
Fax
(214) 276-7333
Organisation at this address
Dallas Vamc
Culberson R. Boren, D.D.S., P.A.
Inferred from a shared address, not stated in the registry.
Clinicians at this address
8

Additional practice sites

  • 3250 W Pleasant Run Rd, Lancaster, TX
  • 4500 S Lancaster Rd, Dallas, TX

Registry record

Primary taxonomy
207Q00000X
207Q00000X
Licence states on file
TX
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2019-04-24

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas