Nesom, Clint Lee

Nesom, Clint Lee is an individual health care provider with primary practice located at 13601 Preston Rd Ste 1000W, Dallas TX 75240-4911. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as his primary health care specialty. Nesom, Clint Lee can be contacted via phone (972) 715-5000.

Contact Information

Primary practice address
13601 Preston Rd Ste 1000W Dallas TX 75240-4911
Phone: (972) 715-5000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X C01142 Arkansas

Profile Details

NPI number 1578559639
LBN Legal business name Nesom, Clint Lee
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 23rd, 2005
Last updated May 5th, 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 1578559639 NPPES
Arkansas MEDICAID 136727701
Arkansas Other 5U298

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