Individual
DR. JOHN P. CLEMENT IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
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
Update your record
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