Individual
CRANDON F CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1901 MEDI PARK, STE 2050, AMARILLO, TX 79106-2110
(806) 355-3352
Mailing address
PO BOX 3780, AMARILLO, TX 79116-3780
(806) 355-3352
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
L1002
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100850140A
—
OK
05
—
10838058
—
NM
01
—
130630101
FIRSTCARE
—
05
—
141091204
—
TX
01
—
8F7703
BLUE CROSS OF TEXAS
TX
01
—
MDL1002
WORKERS COMPENSATION
TX
Enumeration date
03/31/2006
Last updated
06/11/2008
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us