Healthcare Provider Details

I. General information

NPI: 1982354502
Provider Name (Legal Business Name): SOLOMON JOHN RICHARD KLEIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2022
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2801 FRANCISCAN DR
BRYAN TX
77802-2544
US

IV. Provider business mailing address

2800 S TEXAS AVE STE 202
BRYAN TX
77802-5361
US

V. Phone/Fax

Practice location:
  • Phone: 979-776-5967
  • Fax: 979-731-5619
Mailing address:
  • Phone: 979-776-5967
  • Fax: 979-731-5619

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberV2766
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: