IndividualActive
Keith Wixtrom, M.D.
NPI 1639193246 · Family Medicine Physician · Tyler, TX
Keith Wixtrom, M.D. is a Family Medicine Physician provider in Tyler, TX (NPI 1639193246).
Provider details
- NPI number
- 1639193246
- Entity type
- Individual
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- G8515 (TX)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(100/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
7916 S Broadway Ave
Tyler, TX 75703-5274
Phone: (903) 266-5900
Fax: (214) 276-7333
Street-level locationGet directions
Mailing address
308 Hide a Way Ln C
Hideaway, TX 75771-5202
Additional practice locations (2)
- 4500 S Lancaster RdDallas, TX 75216-7167Phone: (214) 857-1911Fax: (214) 276-7333
- 3250 W Pleasant Run RdSuite 160Lancaster, TX 75146-1050Phone: (972) 274-5200Fax: (972) 274-5217
Registry dates
- Enumerated
- 2006-07-27
- Last updated
- 2019-04-24
Frequently asked questions
- What is Keith Wixtrom's NPI number?
- Keith Wixtrom's National Provider Identifier (NPI) is 1639193246, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Keith Wixtrom's specialty?
- Keith Wixtrom is listed in the NPPES registry with a primary specialty of Family Medicine Physician (Allopathic & Osteopathic Physicians).
- Where is Keith Wixtrom located?
- Keith Wixtrom's practice location on file with NPPES is 7916 S Broadway Ave, Tyler, TX 75703-5274.
- What is Keith Wixtrom's phone number?
- The practice phone number listed in the NPPES registry for Keith Wixtrom is (903) 266-5900.
- Is Keith Wixtrom's NPI active?
- Yes — Keith Wixtrom's NPI (1639193246) is active in the NPPES registry as of the last update on 2019-04-24.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.