Individual
DR. GORAN B. G. KLINTMALM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3410 WORTH ST, SUITE 950, DALLAS, TX 75246-2003
(214) 820-2050
(214) 818-6491
Mailing address
3410 WORTH ST, SUITE 950, DALLAS, TX 75246-2003
(214) 820-2050
(214) 818-6491
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
G7835
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
041146403
—
TX
05
—
041146404
—
TX
01
—
8H3710
BCBS
TX
Enumeration date
07/04/2006
Last updated
10/20/2014
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