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Organization
SEAGRAVES FAMILY CLINIC
Active
Organization
SEAGRAVES FAMILY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLIFTON DANE SMITH M.P.A.S., P.A.C., LP (DIRECTOR)
(806) 387-3325
Entity
Organization
Contact information
Practice address
302 MAIN, BOX 1355, SEAGRAVES, TX 79359-0000
(806) 387-3325
Mailing address
302 MAIN, BOX 1355, SEAGRAVES, TX 79359-0000
(806) 387-3325
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0074PL
BLUECROSS BLUESHIELD
TX
Enumeration date
02/15/2007
Last updated
02/19/2008
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