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Individual

DEONNA MICHELLE CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
6500 ROOKIN ST, SUITE 200, HOUSTON, TX 77074-5019
(832) 548-5000
(713) 523-4897
Mailing address
PO BOX 66308, HOUSTON, TX 77266-6308
(832) 548-5076
(713) 523-4897

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
661103
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
080462703
TX
01
661103
TX STATE BOARD OF NURSING APN LICENSURE
Enumeration date
12/22/2011
Last updated
02/10/2022
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