Pedigo, Clark W

Pedigo, Clark W is an individual health care provider with primary practice located at 3302 Boca Chica Blvd , Brownsville TX 78521-5193. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant, which is considered as his primary health care specialty. Pedigo, Clark W can be contacted via phone (956) 982-1001.

Contact Information

Primary practice address
3302 Boca Chica Blvd Brownsville TX 78521-5193
Phone: (956) 982-1001
Fax: (956) 550-9393
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapy Assistant 225200000X 2028090 Texas

Profile Details

NPI number 1508164062
LBN Legal business name Pedigo, Clark W
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 8th, 2011
Last updated Sep 14th, 2015 - about 10 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 1508164062 NPPES
Texas Other 2028090 STATE LICENSE

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