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General NPI Number Information
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NPI Number | 1215241310
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Entity Type | Individual
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Provider Name | KELLY ELIZABETH CLINE MD
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Gender | Female
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Dates
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Enumeration Date | 07/30/2010
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Last Update Date | 08/07/2023
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Provider Practice Location Address
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Address Line | 9835 N LAKE CREEK PKWY
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City | AUSTIN
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State | TX
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Zip | 78717-6210
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Country | US
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Telephone | 936-267-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 5813 SANDALWOOD HOLW
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City | AUSTIN
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State | TX
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Zip | 78731-3623
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Country | US
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Telephone | 512-762-0352
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Fax |
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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 | 207XP3100X
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Taxonomy Name | Pediatric Orthopaedic Surgery Physician
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License Number | R3493
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License Number State | TX
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