Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Keith Wayne Wisniewski, MD

Individual provider Dermatology Physician · NPI 1588792741

Dr. Keith Wayne Wisniewski, MD is a Dermatology in Lubbock, Texas. Graduated from Texas Tech University Health Science Center School of Medicine in 2003, 23 years ago. Practices with Dermatology Associates of West Texas, LLP, an 8-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
23
Trained at
Texas Tech University Health Science Center School of Medicine
Licensed in
TX
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

2202 Ithaca Ave
Lubbock, TX 79410-1332
Phone: (806) 797-1202
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dermatology Physician (primary) Taxonomy 207N00000X · Licence M5588 (TX)

Record details

NPI number1588792741
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 1, 2007
Last updated in NPPESJune 5, 2020
Certification dateJune 5, 2020
Mailing address2202 Ithaca Ave, Lubbock, TX 79410-1332

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyDERMATOLOGY
Medical schoolTEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Graduated 2003 (23 years in practice)
Group practice Dermatology Associates Of West Texas, Llp — 8 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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