Marrietta D. Cline, M.D.

Individual provider Active NPI Pediatrics Physician · Dickinson, TX

NPI 1689604142 · NPPES record last updated Jul 10, 2023

Key facts

NPI
1689604142
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
K1399 (TX)
Practice address
624 FM 517 Rd W
Dickinson, TX 77539-3904
Phone
(281) 534-1300
Fax
(281) 534-1306
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
K1399TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Cline Pediatrics Pediatrics Current
since Jul 23, 2023
Accepting new patients
Chca Clear Lake LP Past Accepting new patients

Locations

3828 Hughes Ct
Ste 204
Dickinson, TX 77539
Phone (281) 534-1300

624 FM 517 Rd W
Dickinson, TX 77539
Phone (281) 534-1300

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FIAFBD/Endpoint/FIAFBD

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X K1399 TX Yes

Addresses

Primary practice location

624 FM 517 Rd W
Dickinson, TX 77539-3904

Mailing address

624 FM 517 Rd W
Dickinson, TX 77539-3904
Phone (281) 534-1300

Other identifiers

IdentifierTypeStateIssuer
0017QDOtherTXBC/BS
00424OtherTXTEXAS CHIP
00606GOtherTXMEDICARE ID
00002OtherTXAETNA EDI PROVIDER ID
121246602MedicaidTX
10024877OtherTXAMERIGROUP
121246604MedicaidTX

Other providers in Dickinson, TX

All providers in Dickinson, TX · Pediatrics Physician in Texas

Sources for this page

Verify at the official NPI Registry.