Clark, Charles B.

Clark, Charles B. is an individual health care provider with primary practice located at 6025 Metropolitan Dr Suite 205, Beaumont TX 77706-2408. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurological Surgery, which is considered as his primary health care specialty. Clark, Charles B. can be contacted via phone (409) 899-4999.

Contact Information

Primary practice address
6025 Metropolitan Dr Suite 205 Beaumont TX 77706-2408
Phone: (409) 899-4999
Fax: (409) 899-3978
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurological Surgery 207T00000X D9396 Texas

Profile Details

NPI number 1770689358
LBN Legal business name Clark, Charles B.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 15th, 2006
Last updated Mar 5th, 2015 - about 9 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770689358 NPPES
Texas MEDICAID 0981946-01
Texas Other 359865

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