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Contact Information

LEONARD L CLARK, CRNA
1801 SAN JUAN DR
SHERMAN, TX75092
 Phone: 903-892-3012
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Nurse Anesthetist, Certified Registered

367500000X 43 Certified Registered Nurse Anesthetist (CRNA)
Indicates primary specialty

NPI Profile & details for LEONARD L CLARK · (Male)

NPI # 1285794768
Status Active
Credentials CRNA (Certified Registered Nurse Anesthetist)
Entity Individual
Enumeration date 12/12/2006
Last updated 06/05/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • OK License # 78396
  • TX License # 562123
  • Other 045542 AANA CERTIFICATION
Hospital affiliation(s)
  • EAST TEXAS MEDICAL CENTER - (Acute Care)
    1000 SOUTH BECKHAM STREET
    TYLER, TX 75701
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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