Individual provider · Type 1 NPI
Madison Clark, PA-C
Medical Physician Assistant · Dallas, TX
NPI number
1992417810
Active
Practice location
5323 Harry Hines Blvd
Dallas, TX 75390-4231
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant | 363AS0400X | None listed |
| Medical Physician Assistant Primary | 363AM0700X | PA16548 (TX) |
Medical Physician Assistant: Definition to come...
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About NPI 1992417810
Madison Clark, PA-C's National Provider Identifier is 1992417810, issued on Dec 22, 2022. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Dallas, TX. The record was last updated on Aug 16, 2023.