Provider Demographics
NPI:1548247810
Name:CLINARD, CATHY (FNP)
Entity type:Individual
Prefix:MS
First Name:CATHY
Middle Name:
Last Name:CLINARD
Suffix:
Gender:F
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:PO BOX 650866
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0866
Mailing Address - Country:US
Mailing Address - Phone:972-715-1999
Mailing Address - Fax:972-233-3666
Practice Address - Street 1:6606 LBJ FWY
Practice Address - Street 2:SUITE 200
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6533
Practice Address - Country:US
Practice Address - Phone:972-715-5000
Practice Address - Fax:972-715-9976
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2015-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX631006363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX155484203Medicaid
TX89N041OtherBCBS
TX155484205Medicaid
TX155484204Medicaid
TXP00101189OtherRAILROAD
TX155484204Medicaid
TX155484205Medicaid
P45982Medicare UPIN
TX89N041OtherBCBS