Individual
SHELBY RAE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
520 E EUCLID AVE, SAN ANTONIO, TX 78212-4414
(210) 581-2837
(210) 853-2718
Mailing address
12047 FM 1957 STE 104, SAN ANTONIO, TX 78253-9244
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
1156851
TX
363LA2100X
Acute Care Nurse Practitioner
1156851
TX
Other
Enumeration date
04/08/2024
Last updated
08/23/2024
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