Individual
DR. CLARK WESLEY BRAZIL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1508 10TH ST, WICHITA FALLS, TX 76301-4401
(940) 322-6671
(940) 322-6676
Mailing address
1508 10TH ST, WICHITA FALLS, TX 76301-4401
(940) 322-6671
(940) 322-6676
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
E1512
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1281834-01
—
TX
Enumeration date
11/17/2005
Last updated
04/12/2013
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