Provider Demographics
NPI:1003870759
Name:CLINE, VIVIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:
Last Name:CLINE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:301 SETON PKWY
Practice Address - Street 2:SUITE 104
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-8002
Practice Address - Country:US
Practice Address - Phone:512-687-2300
Practice Address - Fax:512-687-2350
Is Sole Proprietor?:No
Enumeration Date:2006-04-12
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV11850207RH0003X
TXN0704207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX197265502Medicaid
TX8BP365OtherBCBS OF TX
TXP00725233OtherRAILROAD MEDICARE
OH2347893Medicaid
NVP00361534OtherRAILROAD MEDICARE
TX197265501Medicaid
TXP00725233OtherRAILROAD MEDICARE
TX197265501Medicaid
TX8L3624Medicare PIN