Provider Demographics
NPI:1710230719
Name:CLINE, CALEB B (PA-C)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:B
Last Name:CLINE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 CREEKSIDE
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-8901
Mailing Address - Country:US
Mailing Address - Phone:903-465-9577
Mailing Address - Fax:
Practice Address - Street 1:600 NORTH HIGHLAND
Practice Address - Street 2:STE 104
Practice Address - City:SHERMAN
Practice Address - State:TX
Practice Address - Zip Code:75092-5631
Practice Address - Country:US
Practice Address - Phone:903-870-4609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical