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General NPI Number Information
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NPI Number | 1063702876
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Entity Type | Individual
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Provider Name | THEODORE CARROLL KLEM M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/13/2011
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 9433 BEE CAVES RD BUILDING 3, SUITE 103
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City | AUSTIN
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State | TX
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Zip | 78733
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Country | US
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Telephone | 512-649-7515
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Fax | 512-649-1913
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Provider Business Mailing Address
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Address Line | 9433 BEE CAVES RD BUILDING 3, SUITE 103
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City | AUSTIN
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State | TX
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Zip | 78733
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Country | US
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Telephone | 512-649-7515
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Fax | 512-649-1913
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD23168
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | Q0485
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | BP10039985
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License Number State | TX
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