Provider Demographics
NPI:1730272824
Name:KLEINMAN, SAMUEL E (MD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:E
Last Name:KLEINMAN
Suffix:
Gender:M
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 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:801 7TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2733
Practice Address - Country:US
Practice Address - Phone:682-885-4054
Practice Address - Fax:682-885-7497
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6348207L00000X, 207LP3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX646016OtherFIRSTHEALTH PIN
TX1068963OtherUHC PIN
TX116913100OtherFIRSTCARE PIN
TX4406952OtherAETNA PIN
TX88411YOtherBCBSTX IND PIN
TX140442853Medicaid
TX233823OtherPHCS PIN
TX00N47FOtherBCBSTX GRP PIN
TX100623OtherSUPERIOR PIN
1447220850OtherGRP NPI NUMBER
TX133065609Medicaid
TX10025154OtherAMERIGROUP PIN
TX137345809Medicaid
TX9988551OtherCIGNA PIN
F33110Medicare UPIN
TX88411YOtherBCBSTX IND PIN
TX137345809Medicaid
TX8645J2Medicare PIN