Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | R3493 | TX |
NPI | 1215241310 |
---|---|
Provider Name | Kelly Elizabeth Cline |
First Address | Austin, TX 78759-4107 |
Second Address | Austin, TX 78759-4107 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2010 |
Last Update Date | 21/11/2019 |