Individual
AMY MCCLATCHY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M5368
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
142911
SUPERIOR / CHIP
TX
01
—
152569100
FIRSTCARE HMO
TX
05
—
184027402
—
TX
01
—
8M2791
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/03/2006
Last updated
08/19/2011
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