Provider Demographics
NPI:1790858249
Name:KLEIN & KLEIN ETAL
Entity Type:Organization
Organization Name:KLEIN & KLEIN ETAL
Other - Org Name:KLEIN'S SUPER MARKET - KLEIN'S DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:A
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-351-1190
Mailing Address - Street 1:31090 QUINN RD
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77375-2960
Mailing Address - Country:US
Mailing Address - Phone:281-351-1190
Mailing Address - Fax:281-255-9617
Practice Address - Street 1:31090 QUINN RD
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375-2960
Practice Address - Country:US
Practice Address - Phone:281-351-1190
Practice Address - Fax:281-255-9617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX067153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142278Medicaid
TX4562814Medicare UPIN
TX142278Medicaid