Individual
MR. DENNIS JAY CLARK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
110 MAGEE, GROVETON, TX 75845-4185
(936) 642-0841
(936) 642-0849
Mailing address
PO BOX 459, 110 MAGEE STREET, GROVETON, TX 75845-0459
(936) 642-0841
(936) 642-0849
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA 02393
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203876201
—
TX
05
—
203876202
—
TX
01
—
PA 02393
LICENSE
TX
Enumeration date
11/21/2005
Last updated
07/28/2010
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