Individual
DR. KEVIN LANDIS CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
10415 GATEWAY BLVD W, EL PASO, TX 79925-7905
(915) 592-6885
(915) 595-4059
Mailing address
11604 COLEEN WAY, EL PASO, TX 79936-6922
(915) 593-6205
(915) 592-8868
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4070T
TX
Other
Enumeration date
12/20/2006
Last updated
07/08/2007
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