| Cline Family Practice | |
|
4604 Ne Stallings Dr Nacogdoches TX 75965-1608 | |
| (936) 559-8770 | |
| (936) 559-8773 |
| Full Name | Cline Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 4604 Ne Stallings Dr, Nacogdoches, Texas |
| Authorized Official Name and Position | Mark A Cline (OWNER) |
| Authorized Official Contact | 9365598770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cline Family Practice 4604 Ne Stallings Dr Nacogdoches TX 75965-1608 Ph: (936) 559-8770 | Cline Family Practice 4604 Ne Stallings Dr Nacogdoches TX 75965-1608 Ph: (936) 559-8770 |
| NPI Number | 1992168900 |
|---|---|
| Provider Enumeration Date | 03/29/2016 |
| Last Update Date | 03/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992168900 | NPI | - | NPPES |
| 135176907 | Medicaid | TX | |
| 135176908 | Medicaid | TX | |
| 0026BS | Other | TX | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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