Individual
MR. CLARENCE PETER GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2360 S 8TH ST, BEAUMONT, TX 77701-6401
(409) 239-2779
Mailing address
5550 FOLSOM DR APT 221, BEAUMONT, TX 77706-7252
(409) 333-7069
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
19195530
TX
Other
Enumeration date
07/17/2019
Last updated
06/02/2025
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