Organization Active NPI

Mark R. Klein, D.O. & Associates, PLLC

  • Family Medicine Physician
  • Gainesville, TX
National Provider Identifier
1285809988
Registry record updated Apr 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
MARK R. KLEIN, D.O. & ASSOCIATES, PLLC
Practice address
1625 N. Grand Ave
Gainesville, TX 76240
Phone
(940) 665-9863
NPI assigned
Apr 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2008

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

Authorized official

Name
Mark Robert Klein, DONPI 1982686390
Title
Owner
Phone
(940) 665-9863

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

1625 N. Grand Ave
Gainesville, TX 76240

Mailing address

P.O. Box 1239
Gainesville, TX 76241-1239
Phone (940) 665-9863

Other identifiers 1

IdentifierTypeStateIssuer
112013101MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080808000665 TX Part B Supplier - Clinic/Group Practice 3678647658 Receives reassigned benefits from 2 practitioners
Practice locations: Gainesville, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1285809988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1239",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "762411239",
            "telephone_number": "940-665-9863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 N. GRAND AVE",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "76240",
            "telephone_number": "940-665-9863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK R. KLEIN, D.O. & ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-665-9863",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112013101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.