Hanks, Clyde O

Hanks, Clyde O is an sole proprietor health care provider with primary practice located at 1438 Marlene Pl , Desoto TX 75115-2907. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Hanks, Clyde O can be contacted via phone (214) 850-6580.

Contact Information

Primary practice address
1438 Marlene Pl Desoto TX 75115-2907
Phone: (214) 850-6580
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 3853 Texas
Behavioral Health & Social Service Providers / Clinical 103TC0700X 24895 Texas

Profile Details

NPI number 1114945649
LBN Legal business name Hanks, Clyde O
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 17th, 2006
Last updated Apr 29th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1114945649 NPPES
Texas MEDICAID 131884203

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