Green, Robert Clark

Green, Robert Clark is an individual health care provider with primary practice located at 5002 Cowhorn Creek Rd , Texarkana TX 75503-9766. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Green, Robert Clark can be contacted via phone (903) 614-3000.

Contact Information

Primary practice address
5002 Cowhorn Creek Rd Texarkana TX 75503-9766
Phone: (903) 614-3000
Fax: (903) 614-3525
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X H7153 Texas
Allopathic & Osteopathic Physicians / Pediatrics 208000000X C7275 Arkansas

Profile Details

NPI number 1811997729
LBN Legal business name Green, Robert Clark
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2005
Last updated Apr 8th, 2011 - about 15 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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Identifiers

StateTypeNumberIssuer
All States NPI 1811997729 NPPES
Texas MEDICAID 110615502
Texas Other 117427001

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