Provider Demographics
NPI:1649753559
Name:REED, CLAYTON MCCLAIN (PA)
Entity Type:Individual
Prefix:
First Name:CLAYTON
Middle Name:MCCLAIN
Last Name:REED
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3660 FM 2676
Mailing Address - Street 2:
Mailing Address - City:HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78861-6135
Mailing Address - Country:US
Mailing Address - Phone:210-867-8744
Mailing Address - Fax:
Practice Address - Street 1:2015 KANGAROO TRL
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-5626
Practice Address - Country:US
Practice Address - Phone:210-867-8744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1158128OtherNCCPA NUMBER