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Individual

AMANDA ANNE CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1600 W COLLEGE ST STE 490, GRAPEVINE, TX 76051-2106
(817) 912-8380
(817) 912-8385
Mailing address
1600 W COLLEGE ST STE 490, GRAPEVINE, TX 76051-2106
(817) 912-8380
(817) 912-8385

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA08707
TX

Other

Enumeration date
02/25/2014
Last updated
06/22/2023
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