Individual
AUDRA TESS CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5200 HARRY HINES BLVD, DALLAS, TX 75235-7709
(214) 590-8000
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
Q9593
TX
2086S0102X
Surgical Critical Care Physician
Q9593
TX
Other
Enumeration date
04/29/2013
Last updated
02/07/2025
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