Provider Demographics
NPI:1184664385
Name:NEWMAN, CLYDE THOMAS (MED AND RKT)
Entity Type:Individual
Prefix:MR
First Name:CLYDE
Middle Name:THOMAS
Last Name:NEWMAN
Suffix:
Gender:M
Credentials:MED AND RKT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 DRIFTWOOD ST
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:TX
Mailing Address - Zip Code:78382-7933
Mailing Address - Country:US
Mailing Address - Phone:361-729-3822
Mailing Address - Fax:
Practice Address - Street 1:21 GRIFFITH DR
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:TX
Practice Address - Zip Code:78382-7033
Practice Address - Country:US
Practice Address - Phone:361-790-2260
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist