Provider Demographics
NPI:1114342136
Name:ZBORIL, CLAY RICHARD (PA-C)
Entity Type:Individual
Prefix:MR
First Name:CLAY
Middle Name:RICHARD
Last Name:ZBORIL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1083 COUNTY ROAD 317
Mailing Address - Street 2:
Mailing Address - City:LOUISE
Mailing Address - State:TX
Mailing Address - Zip Code:77455-3926
Mailing Address - Country:US
Mailing Address - Phone:979-578-3693
Mailing Address - Fax:
Practice Address - Street 1:305 SANDY CORNER RD
Practice Address - Street 2:
Practice Address - City:EL CAMPO
Practice Address - State:TX
Practice Address - Zip Code:77437-9535
Practice Address - Country:US
Practice Address - Phone:979-543-5510
Practice Address - Fax:979-543-8420
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-27
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical