Individual
GEOFFREY PHILIP KLINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO, PHD
Contact information
Practice address
855 MONTGOMERY ST, FORT WORTH, TX 76107-2553
(817) 735-2660
Mailing address
PO BOX 99335, FORT WORTH, TX 76199-0335
(817) 735-2660
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101016291
MI
207R00000X
Internal Medicine Physician
N0174
TX
207RC0000X
Cardiovascular Disease Physician
Primary
N0174
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217416101
—
TX
01
—
8CN209
BCBS
TX
01
—
P00929168
RAILROAD MEDICARE
TX
Enumeration date
05/02/2007
Last updated
07/13/2017
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