Provider Demographics
NPI:1437990835
Name:KLINE, BRIAN THOMAS (PHD)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:THOMAS
Last Name:KLINE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:702 CLEVELAND ST APT 2304
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77019-5254
Mailing Address - Country:US
Mailing Address - Phone:716-395-9605
Mailing Address - Fax:713-554-1812
Practice Address - Street 1:702 CLEVELAND ST APT 2304
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77019-5254
Practice Address - Country:US
Practice Address - Phone:716-395-9605
Practice Address - Fax:713-554-1812
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-03
Last Update Date:2025-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39108103TC1900X, 103TC0700X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX39108OtherTEXAS PSYCHOLOGIST LICENSE