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James T. Clark, MD
Specialist in Tyler, Texas
NPI 1073665964

James T. Clark is a Specialist based in Tyler, TX. James T. Clark practices in Tyler, TX and has the professional credentials of MD. The NPI Number for James T. Clark is 1073665964 and holds a License No. D3181 (Texas).

The current practice location address for James T. Clark is 1100 E Lake St, Tyler, TX and can be reached out via phone at 903-595-5522 and via fax at 903-595-3834.

Location: 1100 E Lake St, Tyler, TX, 75701-3343
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073665964
Provider Name
James T. Clark
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1100 E Lake St, Tyler, TX, 75701-3343
Phone Number
903-595-5522
Fax Number
903-595-3834
Provider Enumeration Date
01/18/2007
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
751477994 01 TX TAX ID #
11235461 05 TX
041539337 01 TX RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
1100 E Lake St
City
Tyler
State
Texas
Zip
75701-3343
Phone Number
903-595-5522
Fax Number
903-595-3834
person
Provider Business Mailing Address Details
Address
1100 E Lake St
City
Tyler
State
Texas
Zip
75701-3343
Phone Number
903-595-5522
Fax Number
903-595-3834
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
D3181 (Texas)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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