Provider Demographics
NPI:1902988314
Name:CLINCY, HERMAN SHERMAINE JR (HEALH SERVICES TECH)
Entity Type:Individual
Prefix:MR
First Name:HERMAN
Middle Name:SHERMAINE
Last Name:CLINCY
Suffix:JR
Gender:M
Credentials:HEALH SERVICES TECH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:2200 BERGQUIST DR., SUITE 1
Mailing Address - Street 2:
Mailing Address - City:LACKLAND AFB
Mailing Address - State:TX
Mailing Address - Zip Code:78236-5301
Mailing Address - Country:US
Mailing Address - Phone:210-645-0578
Mailing Address - Fax:210-292-6845
Practice Address - Street 1:2200 BERGQUIST DR., SUITE 1
Practice Address - Street 2:
Practice Address - City:LACKLAND AFB
Practice Address - State:TX
Practice Address - Zip Code:78236-5301
Practice Address - Country:US
Practice Address - Phone:210-645-0578
Practice Address - Fax:210-292-6845
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other