MEDICARE: DR. RONALD S KLINE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208C00000X	Colon & Rectal Surgery Physician	E1000	TX

General Provider Information

NPI Number	:	1184612905
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RONALD S KLINE M.D.

Provider Business Mailing Address
First Line	:	515 W MAYFIELD RD
Second Line	:	SUITE 416
City	:	ARLINGTON
State	:	TX
Zip	:	76014-2083
Country	:	US
Telephone Number	:	817-417-8748
Fax Number	:	817-419-8788

Provider Business Practice Location Address
First Line	:	515 W MAYFIELD RD
Second Line	:	SUITE 416
City	:	ARLINGTON
State	:	TX
Zip	:	76014-2083
Country	:	US
Telephone Number	:	817-417-8748
Fax Number	:	817-419-8788

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/06/2005
Last Update Date	:	05/20/2010

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