Basic Information
| Provider Information | |||||||||
| NPI: | 1104914332 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KLEIN | ||||||||
| FirstName: | ADAM | ||||||||
| MiddleName: | E | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4222 W ALABAMA ST | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770274902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7138508255 | ||||||||
| FaxNumber: | 7138508255 | ||||||||
| Practice Location | |||||||||
| Address1: | 6040 UNIVERSITY TOWN CENTRE DR | ||||||||
| Address2: | |||||||||
| City: | MORGANTOWN | ||||||||
| State: | WV | ||||||||
| PostalCode: | 265012421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8559882273 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/11/2006 | ||||||||
| LastUpdateDate: | 04/15/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/15/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 24800 | WV | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207X00000X | K6054 | TX | N | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 8X9512 | 01 | TX | BLUE CROSS BLUE SHIELD | OTHER | 186880403 | 05 | TX | MEDICAID |