Individual
DR. ANTHONY ELMORE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
45 NE LOOP 410, SUITE 400, SAN ANTONIO, TX 78216-5832
(210) 375-7720
Mailing address
3510 N LOOP 1604 E, SAN ANTONIO, TX 78247-2303
(210) 375-7790
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G4916
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1264178-04
—
TX
Enumeration date
11/22/2005
Last updated
10/11/2018
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