Individual
BRANDI NICOLE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4900 MUELLER BLVD, SUITE 3S.066C, AUSTIN, TX 78723-3079
(512) 324-0165
Mailing address
4900 MUELLER BLVD, SUITE 3S.066C, AUSTIN, TX 78723-3079
(512) 324-0165
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
BP10059342
TX
Other
Enumeration date
04/24/2017
Last updated
04/24/2017
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