| Doctor Name: | THOMAS STEPHEN CLARK |
| NPI Number: | 1295704872 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP |
| License Number: | AP111188 |
| Business Practice Address: | 3051 Garden Ave Ste 159 Mcwethy Troop Medical Clinic Jbsa Ft Sam Houston, TX - 782347537 |
| Business Phone Number: | 2102954667 |
| Business Fax Number: | 2102954895 |
| Mailing Address: | 3051 Garden Ave Ste 159, Mcwethy Troop Medical Clinic JBSA FT SAM HOUSTON |
| State: | TX |
| Postal Code: | 782347537 |
| Phone Number: | 2102954667 |
| Fax Number: | 2102954895 |
| NPI Enumeration Date: | 03/16/2006 |
| NPI Last Update Date: | 08/08/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | AP111188 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |