Individual
MARY KATHRYN CLAYSHULTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3500 CAMP BOWIE BLVD, FORT WORTH, TX 76107-2644
(575) 993-9917
Mailing address
3500 CAMP BOWIE BLVD, FORT WORTH, TX 76107-2644
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
363AS0400X
Surgical Physician Assistant
—
—
Other
Enumeration date
03/04/2026
Last updated
03/04/2026
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