Provider Demographics
NPI:1043011752
Name:KLEIN, NICOLAS (PA)
Entity type:Individual
Prefix:
First Name:NICOLAS
Middle Name:
Last Name:KLEIN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2608 BROCKTON DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78758-4414
Mailing Address - Country:US
Mailing Address - Phone:512-654-4050
Mailing Address - Fax:
Practice Address - Street 1:2608 BROCKTON DR UNIT B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78758-4414
Practice Address - Country:US
Practice Address - Phone:512-654-4050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-20
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant