Clark, Charles S

Clark, Charles S is an individual health care provider with primary practice located at 6118 Parkway Dr. , Corpus Christi TX 78414-2455. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Clark, Charles S can be contacted via phone (361) 883-2000.

Contact Information

Primary practice address
6118 Parkway Dr. Corpus Christi TX 78414-2455
Phone: (361) 883-2000
Fax: (361) 561-1354
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X D9397 Texas

Profile Details

NPI number 1114921913
LBN Legal business name Clark, Charles S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2005
Last updated Jan 30th, 2014 - about 10 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 1114921913 NPPES
Texas Other 200035255 MEDICARE B RAILROAD
Texas MEDICAID 126242003 MEDICARE B RAILROAD

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