Individual
CLAYTON E WHITNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1327 TROUP HWY, TYLER, TX 75701-4443
(903) 531-4733
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
G0285
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
123448604
—
TX
05
—
123448605
—
TX
01
—
8BC079
BCBS OF TEXAS
TX
01
—
TIN PLUS 021
TRICARE
TX
Enumeration date
01/31/2006
Last updated
10/14/2014
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