Clark, Dana Gibbs
Clark, Dana Gibbs is an individual health care provider with primary practice located at 2314 Shadydale Dr , Arlington TX 76012-5428. She recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Otolaryngic Allergy, Allopathic & Osteopathic Physicians / Otolaryngology. Allopathic & Osteopathic Physicians / Otolaryngology is her primary health care specialty. Clark, Dana Gibbs can be contacted via phone (178) 988-4261.Contact Information
Primary practice address
2314 Shadydale Dr
Arlington TX 76012-5428
Phone: (178) 988-4261
Fax: (817) 259-2613
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | K7021 | Texas |
| Allopathic & Osteopathic Physicians / Otolaryngic Allergy | 207YX0602X | K7021 | Texas |
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | K7021 | Texas |
Profile Details
| NPI number | 1720009236 |
|---|---|
| LBN Legal business name | Clark, Dana Gibbs |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2006 |
| Last updated | May 16th, 2023 - about 2 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 | 1720009236 | NPPES |
| Texas | MEDICAID | 153107101 |
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