Organization
KLR PHYSICIAN GROUP
Active
Other names
The KLR Physician Group
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEE L RANDLE DO (CEO)
(267) 981-0308
Entity
Organization
Contact information
Practice address
3450 E. BROAD STREET, SUITE 120, MANSFIELD, TX 76063-7606
(267) 981-0308
Mailing address
3540 E BROAD ST STE 120, MANSFIELD, TX 76063-5633
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
P3570
TX
Other
Enumeration date
04/23/2015
Last updated
09/11/2025
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