Summer Clark, M.D.
Dermatology, MOHS-Micrographic Surgery in Amarillo, TX. Individual provider (NPI-1).
NPI number1154736643
StatusActive
Last updated in NPPESJun 4, 2019
Details
- NPI
- 1154736643
- Entity type
- Individual (NPI-1)
- Name
- Summer Clark
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 24, 2014
- Last updated
- Jun 4, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ND0101X | Dermatology, MOHS-Micrographic Surgery | S1580 | TX | Yes |
Practice location
1611 Wallace BlvdAmarillo, TX 79106-1799
Phone 063-544-9008
Mailing address
1611 Wallace BlvdAmarillo, TX 79106-1799
Phone 806-354-4900
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