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Individual

CLINTON THOMAS WERNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2300 LONE STAR RD, MANSFIELD, TX 76063-8744
(817) 939-1588
Mailing address
10317 HACKAMORE CIR, MANSFIELD, TX 76063-8205
(178) 939-1588

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
814395
TX
367500000X
Certified Registered Nurse Anesthetist
Primary
AP136339
TX

Other

Enumeration date
12/12/2017
Last updated
10/07/2022
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