Individual
DR. ELLIOTT IRVING CLEMENCE III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7500 BARLITE BLVD STE 309, SAN ANTONIO, TX 78224-1361
(210) 924-9000
(210) 924-7300
Mailing address
7500 BARLITE BLVD STE 309, SAN ANTONIO, TX 78224-1361
(210) 924-9000
(210) 924-7300
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
K0004
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0U58R
BLUECROSS BLUESHIELD
TX
05
—
100345101
—
TX
Enumeration date
11/02/2006
Last updated
03/20/2015
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