Rebecca Clark, MS, PA-C
Dermatology in Bellaire, TX. Individual provider (NPI-1).
NPI number1578776571
StatusActive
Last updated in NPPESJan 2, 2008
Details
- NPI
- 1578776571
- Entity type
- Individual (NPI-1)
- Name
- Rebecca Clark
- Credential
- MS, PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- May 7, 2007
- Last updated
- Jan 2, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | PA02134 | TX | Yes |
| 207NI0002X | Dermatology, Clinical & Laboratory Dermatological Immunology | PA02134 | TX | |
| 207NP0225X | Dermatology, Pediatric Dermatology | PA02134 | TX | |
| 207NS0135X | Dermatology, Procedural Dermatology | PA02134 | TX |
Practice location
6565 West Loop SSuite 800
Bellaire, TX 77401-3500
Phone 713-661-4383 · Fax 713-661-4346
Mailing address
6565 West Loop SSuite 800
Bellaire, TX 77401-3500
Phone 713-661-4383 · Fax 713-661-4346
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