Individual
MR. GERARDO CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OPTICIAN
Contact information
Practice address
4124 AYERS ST, CORPUS CHRISTI, TX 78415-5315
(361) 854-0115
(361) 854-0116
Mailing address
4124 AYERS ST, CORPUS CHRISTI, TX 78415-5315
(361) 854-0115
(361) 854-0116
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3101
TX
Other
Enumeration date
06/05/2012
Last updated
06/05/2012
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