NPI | 1174902621 |
---|---|
Doing Business As | CLARK PLASTIC SURGERY |
Doing Business As | CLARK PLASTIC AND HAND SURGERY |
Entity Type | Organization |
Authorized Contact | STEVEN A CLARK Authorized Official/Owner 469-675-3659 |
Organization Subpart ? | No |
Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: TX N3567) |
Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX N3567) |
2082S0105X Plastic Surgery, Surgery of the Hand (Licence: TX N3567) | |
2086S0105X Surgery, Surgery of the Hand (Licence: TX N3567) | |
Enumeration Date | 2015-05-29 |
Last Update Date | 2025-07-24 |