Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | K1226 | TX |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | K1226 | TX |
NPI | 1376500447 |
---|---|
Provider Name | Kelly Klein |
First Address | Lubbock, TX 79408-5865 |
Second Address | Lubbock, TX 79430-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 02/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0001KH | BLUE CROSS BLUE SHIELD (01) | TX |
100192101 | FIRSTCARE LHC (01) | TX |
100192105 | FIRSTCARE INDIVIDUAL (01) | TX |
130893408 | (05) | TX |
162693901 | LHC MEDICAID (01) | TX |
8J9140 | BCBS LHC (01) | TX |
G50574 | (02) | TX |