Clark, Paul

Clark, Paul is an sole proprietor health care provider with primary practice located at 3551 Roger Brooke Dr , Fort Sam Houston TX 78234-4504. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Pediatric Radiology. Allopathic & Osteopathic Physicians / Pediatric Radiology is his primary health care specialty. Clark, Paul can be contacted via phone (210) 539-0784.

Contact Information

Primary practice address
3551 Roger Brooke Dr Fort Sam Houston TX 78234-4504
Phone: (210) 539-0784
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 0102202652 Virginia
Allopathic & Osteopathic Physicians / Pediatric Radiology 2085P0229X 0102202652 Virginia

Profile Details

NPI number 1225052467
LBN Legal business name Clark, Paul
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 27th, 2006
Last updated Oct 26th, 2020 - about 4 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1225052467 NPPES
Virginia MEDICAID 1225052467

Popular Providers