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NPI Code Detail

MEDICARE: MRS. SYLVIA CLARK

MEDICARE:  MRS. SYLVIA  CLARK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator32487TX
2104100000XSocial Worker32487TX

General Provider Information

NPI Number : 1225499346
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SYLVIA CLARK
Provider Business Mailing Address
First Line : 7328 BAYBERRY LN
Second Line :
City : DALLAS
State : TX
Zip : 75249-1013
Country : US
Telephone Number : 214-693-0303
Fax Number : 972-296-8418
Provider Business Practice Location Address
First Line : 1221 W BEN WHITE BLVD STE 210A
Second Line :
City : AUSTIN
State : TX
Zip : 78704-7182
Country : US
Telephone Number : 512-960-4533
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2016
Last Update Date : 11/10/2021

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Directions to “ MRS. SYLVIA CLARK ” Practice Location

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