| Mr Dennis Jay Clark Jr, PA C | |
|
110 Magee, Groveton, TX 75845-4185 | |
| (936) 642-0841 | |
| (936) 642-0849 |
| Full Name | Mr Dennis Jay Clark Jr |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Location | 110 Magee, Groveton, Texas |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750364188 | NPI | - | NPPES |
| 203876201 | Medicaid | TX | |
| PA 02393 | Other | TX | LICENSE |
| 203876202 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363A00000X | Physician Assistant | PA 02393 (Texas) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Dennis Jay Clark Jr, PA C Po Box 459, 110 Magee Street, Groveton, TX 75845-0459 Ph: (936) 642-0841 | Mr Dennis Jay Clark Jr, PA C 110 Magee, Groveton, TX 75845-4185 Ph: (936) 642-0841 |
Mr. Ira Richard Gillum, PA C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 104 S Devine, Groveton, TX 75845 Phone: 936-642-0841 Fax: 936-642-0849 | |
Keith Edward Jones, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 110 Magee Street, Groveton, TX 75845 Phone: 936-642-0841 Fax: 936-642-0849 |