Individual
MR. CLIFFORD D. SCOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
525 MAGNOLIA TRL, DESOTO, TX 75115-1416
(817) 501-5681
Mailing address
525 MAGNOLIA TRL, DESOTO, TX 75115-1416
(817) 501-5681
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
1016214
TX
Other
Enumeration date
12/04/2008
Last updated
12/04/2008
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