| Mrs Cameron Whitaker Clark, PA | |
|
2727 E Southlake Blvd, Southlake, TX 76092-6613 | |
| (682) 885-6000 | |
| (682) 885-6050 |
| Full Name | Mrs Cameron Whitaker Clark |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant |
| Location | 2727 E Southlake Blvd, Southlake, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760758320 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | PA007766 (Texas) | Secondary |
| 363A00000X | Physician Assistant | PA07766 (Texas) | Primary |
| Entity Name | Cook Childrens Physician Network |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1750369203 PECOS PAC ID: 7719884584 Enrollment ID: O20040128000800 |
| Entity Name | Texas Physician Resources, LLP |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1639413289 PECOS PAC ID: 7012161375 Enrollment ID: O20130214000159 |
| Entity Name | Texas Medicine Resources, LLP |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376581900 PECOS PAC ID: 5890688212 Enrollment ID: O20130702000785 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Cameron Whitaker Clark, PA Po Box 733784, Dallas, TX 75373-3784 Ph: (682) 885-1855 | Mrs Cameron Whitaker Clark, PA 2727 E Southlake Blvd, Southlake, TX 76092-6613 Ph: (682) 885-6000 |
Micah Christian Bowman, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2419 W Southlake Blvd Ste 100, Southlake, TX 76092 Phone: 469-535-6842 |
Lauren Ashley Shepherd, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 505 S Nolen Dr Ste B, Southlake, TX 76092 Phone: 817-410-7777 |
Christine D Lawson, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3065 W Southlake Blvd # 140, Southlake, TX 76092 Phone: 817-380-5911 Fax: 817-385-6579 |
Halie Annette Moreno, PA-C, MPAS, MPH Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 100 W Southlake Blvd Ste 420, Southlake, TX 76092 Phone: 870-918-2463 |
Melissa Wedesky, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1130 N Kimball Ave Ste 100, Southlake, TX 76092 Phone: 817-865-3564 |
Kristi Lee West, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2727 E Southlake Blvd, Southlake, TX 76092 Phone: 682-885-6000 Fax: 682-885-6026 |
Lisa Tshuma, PA Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 321 W Southlake Blvd, Suite #180, Southlake, TX 76092 Phone: 817-416-2905 Fax: 817-416-7284 |