Desraj Clark

NPI #1396109666 in Fort Bliss, Texas

Provider Information

NPI Number: 1396109666
Entity Type: Individual
Name: Desraj Clark
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Orthopaedic Surgery
Enumeration Date: Apr 12, 2016
Last Updated: Oct 30, 2023

Practice Location

Address: 18511 HIGHLANDER MEDICS ST
City: Fort Bliss
State: Texas
ZIP Code: 79906-5327
Phone: (915) 742-0353

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Military Health Care Provider	171000000X
Student in an Organized Health Care Education/Training Program	390200000X
Orthopaedic Surgery	207X00000X	Primary

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