KLR Physician Group

Primary specialty

Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X

License

P3570 Issued in TX

Legal business name

KLR PHYSICIAN GROUP

Practice address

3450 E. Broad Street
Suite 120
Mansfield, TX 76063-7606

Phone

(267) 981-0308

NPI assigned

Apr 23, 2015

Last updated

Sep 11, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kellee L Randle, DO

Title

Ceo

Phone

(267) 981-0308

Specialties & licenses 1

Addresses

Other names 1

• The KLR Physician Group Former legal business name

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1429747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1033506456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3540 E BROAD ST STE 120",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760635633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 E. BROAD STREET",
            "address_2": "SUITE 120",
            "city": "MANSFIELD",
            "state": "TX",
            "postal_code": "760637606",
            "telephone_number": "267-981-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLR PHYSICIAN GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-23",
        "last_updated": "2025-09-11",
        "certification_date": "2022-09-23",
        "status": "A",
        "authorized_official_last_name": "RANDLE",
        "authorized_official_first_name": "KELLEE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "267-981-0308",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TX",
            "license": "P3570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The KLR Physician Group",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "The KLR Physician Group",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Nursing Facility/Intermediate Care Facility in Mansfield, TX
• Providers in Mansfield, TX by specialty
• Nursing Facility/Intermediate Care Facility in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.