Provider Demographics
NPI:1881882249
Name:BIGGS, CLYDE MCLAIN (FNP)
Entity type:Individual
Prefix:MR
First Name:CLYDE
Middle Name:MCLAIN
Last Name:BIGGS
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10614 MOSSBANK LN
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-3422
Mailing Address - Country:US
Mailing Address - Phone:210-699-6213
Mailing Address - Fax:210-657-4243
Practice Address - Street 1:8530 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5504
Practice Address - Country:US
Practice Address - Phone:210-657-4241
Practice Address - Fax:210-657-4243
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX581586251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ40774Medicare UPIN