Individual
MARRIETTA D. CLINE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
K1399
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00002
AETNA EDI PROVIDER ID
TX
01
—
0017QD
BC/BS
TX
01
—
00424
TEXAS CHIP
TX
01
—
00606G
MEDICARE ID
TX
01
—
10024877
AMERIGROUP
TX
05
—
121246602
—
TX
05
—
121246604
—
TX
Enumeration date
07/03/2006
Last updated
07/10/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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