Brazil, Clark Wesley
Brazil, Clark Wesley is an sole proprietor health care provider with primary practice located at 1508 10Th St , Wichita Falls TX 76301-4401. He recently has only one registered license in Allopathic & Osteopathic Physicians / Vascular Surgery, which is considered as his primary health care specialty. Brazil, Clark Wesley can be contacted via phone (940) 322-6671.Contact Information
Primary practice address
1508 10Th St
Wichita Falls TX 76301-4401
Phone: (940) 322-6671
Fax: (940) 322-6676
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | E1512 | Texas |
Profile Details
| NPI number | 1073595708 |
|---|---|
| LBN Legal business name | Brazil, Clark Wesley |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 17th, 2005 |
| Last updated | Apr 12th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073595708 | NPPES |
| Texas | MEDICAID | 1281834-01 |
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