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Individual

CLAY F ISTRE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
16755 HUEBNER RD, SAN ANTONIO, TX 78248-2342
(210) 493-4357
(210) 493-4355
Mailing address
2550 N THUNDERBIRD CIR, SUITE 303, MESA, AZ 85215-1214
(480) 455-4932
(480) 776-0025

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA09534
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
343919201
TX
05
343919202
TX
05
343919203
TX
Enumeration date
04/21/2010
Last updated
06/26/2015
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