Dr. Clark Wesley Brazil
Vascular Surgeon
1508 10th St
Wichita Falls
, Texas 76301-4401
Dr. Clark Wesley Brazil
Vascular Surgeon
1508 10th St
Wichita Falls
, Texas 76301-4401
(940) 322-6676
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About
Features
Specialties
- Vascular Surgeon
Languages spoken
- English
Location
First Address
- Dr. Clark Wesley Brazil
- 1508 10th St
- Wichita Falls, TX
- Zip : 76301-4401
- Fax : (940) 322-6676
- Phone : (940) 322-6671
Second Address
- Dr. Clark Wesley Brazil
- 1508 10th St
- Wichita Falls, TX
- Zip : 76301-4401
- Fax : (940) 322-6676
- Phone : (940) 322-6671
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0129X | Vascular Surgeon | E1512 | TX |
National Provider Identifier
| NPI | 1073595708 |
|---|---|
| Provider Name | Dr. Clark Wesley Brazil |
| First Address | Wichita Falls, TX 76301-4401 |
| Second Address | Wichita Falls, TX 76301-4401 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/11/2005 |
| Last Update Date | 12/04/2013 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 1281834-01 | (05) | TX |
| B21478 | (02) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.