Provider Demographics
NPI:1760427710
Name:KLINE, DIANA LYNN (PA)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:LYNN
Last Name:KLINE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:LYNN
Other - Last Name:BELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:4110 LEIGHTON LN
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-6299
Mailing Address - Country:US
Mailing Address - Phone:972-473-7544
Mailing Address - Fax:
Practice Address - Street 1:3600 COMMUNICATIONS PKWY STE 675
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8162
Practice Address - Country:US
Practice Address - Phone:972-473-7544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2020-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA02585363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8G5485Medicare ID - Type UnspecifiedMEDICARE