Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 37853 | TX |
NPI | 1811486731 |
---|---|
Provider Name | Dr. Kari Kathleen Cleland |
First Address | Round Rock, TX 78681-1149 |
Second Address | Round Rock, TX 78681-1149 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2018 |
Last Update Date | 15/09/2021 |