Clark, Roger Dale

Clark, Roger Dale is an individual health care provider with primary practice located at 4555 E University Blvd Ste C7 , Odessa TX 79762-8137. He recently has only one registered license in Speech, Language and Hearing Service Providers / Hearing Instrument Specialist, which is considered as his primary health care specialty. Clark, Roger Dale can be contacted via phone (432) 444-5200.

Contact Information

Primary practice address
4555 E University Blvd Ste C7 Odessa TX 79762-8137
Phone: (432) 444-5200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Speech, Language and Hearing Service Providers / Hearing Instrument Specialist 237700000X 80241 Texas

Profile Details

NPI number 1992976542
LBN Legal business name Clark, Roger Dale
Credentials HIS
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 21st, 2008
Last updated Jan 14th, 2022 - about 3 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 1992976542 NPPES
Texas Other 07386906 DRIVERS LICENSE

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