Organization
CLINE FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK A CLINE M.D. (OWNER)
(936) 559-8770
Entity
Organization
Contact information
Practice address
4604 NE STALLINGS DR, NACOGDOCHES, TX 75965-1608
(936) 559-8770
(936) 559-8773
Mailing address
4604 NE STALLINGS DR, NACOGDOCHES, TX 75965-1608
(936) 559-8770
(936) 559-8773
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0026BS
MEDICARE PTAN
TX
05
—
135176907
—
TX
05
—
135176908
—
TX
Enumeration date
03/29/2016
Last updated
03/29/2016
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