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1568401594
BAYLEN CLINT BASTIBLE
FORT WORTH, TX
NPI
1568401594
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: TX PA04507)
Enumeration Date
2006-06-05
Last Update Date
2019-05-07
Business Address
BAYLEN CLINT BASTIBLE PA-C
6551 HARRIS PKWY SUITE 250
FORT WORTH, TX 76132-6103
Phone number: 817-263-6116
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Mailing Address
BAYLEN CLINT BASTIBLE PA-C
PO BOX 100189
FORT WORTH, TX 76185-0189
Phone number: 817-731-0230
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