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Individual

DR. CLYDE CORWIN CLYBOURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1211B E CLIFF DR, EL PASO, TX 79902-4734
(915) 591-6226
(915) 308-9433
Mailing address
6101 BLUE LAGOON DR STE 200, MIAMI, FL 33126-3168
(844) 630-0700
(877) 374-1924

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M7914
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
193932408
TX
01
714478
MEDICARE
Enumeration date
10/18/2006
Last updated
09/19/2023
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