TIMOTHY MICHAEL CLARK

TYLER, TX
NPI1912017039
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: TX  074887)
Enumeration Date2006-08-30
Last Update Date2017-10-23
Business Address
TIMOTHY MICHAEL CLARK CRNA
800 E DAWSON ST
TYLER, TX 75701-2036
Phone number: 903-531-2668
Mailing Address
TIMOTHY MICHAEL CLARK CRNA
PO BOX 841656
DALLAS, TX 75284-1656
Phone number: 903-531-4522
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