Smith-Clark, Takela

Smith-Clark, Takela is an individual health care provider with primary practice located at 2918 Dogwood Blossom Trl , Pearland TX 77581-5035. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Smith-Clark, Takela can be contacted via phone (832) 633-7962.

Contact Information

Primary practice address
2918 Dogwood Blossom Trl Pearland TX 77581-5035
Phone: (832) 633-7962
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 1033007 Texas

Profile Details

NPI number 1740864610
LBN Legal business name Smith-Clark, Takela
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date May 7th, 2021
Last updated May 7th, 2021 - 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 1740864610 NPPES
Texas Other 1033007 BON LICENSE

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