JACOB ZACHARY CLARK

AUSTIN, TX
NPI1093282410
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: TX  AP140355)
Enumeration Date2018-10-24
Last Update Date2020-09-21
Business Address
JACOB ZACHARY CLARK CRNA
3705 MEDICAL PKWY STE 570
AUSTIN, TX 78705-1024
Phone number: 512-454-2554
Mailing Address
JACOB ZACHARY CLARK CRNA
PO BOX 840853
DALLAS, TX 75284-0853
Phone number: 972-233-1999
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