Individual
JOHN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5622 E SAM HOUSTON PKWY N, HOUSTON, TX 77015-3249
(281) 452-7575
Mailing address
PO BOX 841969, DALLAS, TX 75284-1969
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L9657
TX
Other
Enumeration date
08/10/2005
Last updated
05/05/2011
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