Individual
DR. JOHN P. CLEMENT IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
8401 DATAPOINT DR, SUITE 600, SAN ANTONIO, TX 78229-5900
(210) 616-7700
(210) 616-7709
Mailing address
8401 DATAPOINT DR, SUITE 600, SAN ANTONIO, TX 78229-5900
(210) 616-7700
(210) 616-7709
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
L1003
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
047456110
—
TX
01
—
047456111
CSHCN
TX
01
—
047456112
STRIC MEDICAID
TX
01
—
L1003
TEXAS MEDICAL LICENSE
TX
Enumeration date
02/28/2006
Last updated
03/24/2016
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