Organization
GLORIA CLARK, MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLORAI CLARK M.D. (OWNER)
(915) 598-7900
Entity
Organization
Contact information
Practice address
10201 GATEWAY BLVD W, SUITE 400, EL PASO, TX 79925-7652
(915) 598-7900
(915) 598-7902
Mailing address
10201 GATEWAY BLVD W, SUITE 400, EL PASO, TX 79925-7652
(915) 598-7900
(915) 598-7902
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
J8961
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096531102
—
TX
Enumeration date
06/01/2008
Last updated
06/01/2008
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