Clark, Desraj

Clark, Desraj is an individual health care provider with primary practice located at 18511 Highlander Medics St , Fort Bliss TX 79906-5327. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Military Health Care Provider, Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Orthopaedic Surgery. Allopathic & Osteopathic Physicians / Orthopaedic Surgery is his primary health care specialty. Clark, Desraj can be contacted via phone (915) 742-0353.

Contact Information

Primary practice address
18511 Highlander Medics St Fort Bliss TX 79906-5327
Phone: (915) 742-0353
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Military Health Care Provider 171000000X
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 30773 Nebraska

Profile Details

NPI number 1396109666
LBN Legal business name Clark, Desraj
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 12th, 2016
Last updated Oct 30th, 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.

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