Individual
DAVID MCCLELLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2900 E 29TH ST, BRYAN, TX 77802-2622
(979) 776-8440
(979) 776-6905
Mailing address
2900 E 29TH ST, BRYAN, TX 77802-2622
(979) 776-8440
(979) 776-6905
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E4511
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115214207
—
TX
01
—
8BR214
BLUE CROSS BLUE SHIELD
TX
Enumeration date
08/12/2006
Last updated
02/01/2016
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