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General NPI Number Information
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NPI Number | 1285809988
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Entity Type | Organization
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Legal Business Name | MARK R. KLEIN, D.O. & ASSOCIATES, PLLC
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 04/24/2008
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Provider Practice Location Address
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Address Line | 1625 N. GRAND AVE
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City | GAINESVILLE
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State | TX
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Zip | 76240
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Country | US
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Telephone | 940-665-9863
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Fax |
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Provider Business Mailing Address
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Address Line | P.O. BOX 1239
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City | GAINESVILLE
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State | TX
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Zip | 76241-1239
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Country | US
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Telephone | 940-665-9863
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MARK ROBERT KLEIN
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Credential | DO
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Telephone | 940-665-9863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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