Clark, Gregory Scott

Clark, Gregory Scott is an individual health care provider with primary practice located at 1121 E Southeast Loop 323 Ste 204 , Tyler TX 75701. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Professional is his primary health care specialty. Clark, Gregory Scott can be contacted via phone (903) 581-0933.

Contact Information

Primary practice address
1121 E Southeast Loop 323 Ste 204 Tyler TX 75701
Phone: (903) 581-0933
Fax: (903) 581-0933
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 31769 Texas
Behavioral Health & Social Service Providers / Professional 101YP2500X 78242 Texas

Profile Details

NPI number 1881055911
LBN Legal business name Clark, Gregory Scott
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 17th, 2016
Last updated Oct 24th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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