Clark, Kenneth Dale

Clark, Kenneth Dale is an individual health care provider with primary practice located at 9303 Pinecroft Dr , The Woodlands TX 77380-3181. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist, which is considered as his primary health care specialty. Clark, Kenneth Dale can be contacted via phone (281) 297-6445.

Contact Information

Primary practice address
9303 Pinecroft Dr The Woodlands TX 77380-3181
Phone: (281) 297-6445
Fax: (281) 297-6460
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist 222Z00000X 400 Texas

Profile Details

NPI number 1598046401
LBN Legal business name Clark, Kenneth Dale
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 6th, 2011
Last updated Sep 27th, 2011 - about 14 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 1598046401 NPPES
Texas Other 094010801 GROUP MEDICAID NUMBER
Texas Other 00J21A GROUP MEDICAID NUMBER

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