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Individual

CLARA SOUS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BDS, MSD

Contact information

Practice address
10123 LAKE CREEK PKWY BLDG 1, AUSTIN, TX 78729-1755
(512) 335-3600
Mailing address
10123 LAKE CREEK PKWY BLDG 1, AUSTIN, TX 78729-1755
(512) 335-3600

Taxonomy

Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
004533
OH
1223P0300X
Periodontics
Primary
42087
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
004533
OH
Enumeration date
07/19/2022
Last updated
01/13/2026
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