Provider Demographics
NPI:1356183420
Name:MAZE, CLAYTON ALLAN (FNP-C)
Entity type:Individual
Prefix:
First Name:CLAYTON
Middle Name:ALLAN
Last Name:MAZE
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13349 TERLINGUA CREEK DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-3233
Mailing Address - Country:US
Mailing Address - Phone:214-430-7467
Mailing Address - Fax:
Practice Address - Street 1:4280 MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-3080
Practice Address - Country:US
Practice Address - Phone:972-464-2510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-10
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1166392363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily