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Individual
MR. THEODORE CARROLL KLEM
Active
Individual
MR. THEODORE CARROLL KLEM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BP10039985
TX
207R00000X
Internal Medicine Physician
MD23168
ME
207R00000X
Internal Medicine Physician
Primary
Q0485
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
375277YKXV
MEDICARE PTAN
TX
01
—
375277YKXY
MEDICARE PTAN
TX
01
—
375277YLP1
MEDICARE PTAN
TX
01
—
375277YLP2
MEDICARE PTAN
TX
Enumeration date
04/13/2011
Last updated
10/31/2023
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