Healthcare Provider Details

I. General information

NPI: 1689203473
Provider Name (Legal Business Name): AUSTIN KLEINT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2020
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6651 MAIN ST
HOUSTON TX
77030-2351
US

IV. Provider business mailing address

200 MULLINS DR
LEBANON OR
97355-3983
US

V. Phone/Fax

Practice location:
  • Phone: 832-824-1000
  • Fax:
Mailing address:
  • Phone: 541-259-0235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberV7244
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: