Provider Demographics
NPI:1730196320
Name:BYROAD, CLARK CLAIRE (DC)
Entity type:Individual
Prefix:DR
First Name:CLARK
Middle Name:CLAIRE
Last Name:BYROAD
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 N VALLEY PKWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-3437
Mailing Address - Country:US
Mailing Address - Phone:972-219-0434
Mailing Address - Fax:
Practice Address - Street 1:575 N VALLEY PKWY
Practice Address - Street 2:SUITE 100
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-3437
Practice Address - Country:US
Practice Address - Phone:972-219-0434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4646111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1861669962OtherGROUP NPI FOR CLARK C. BYROAD
TXTXB114954OtherCLARK C BYROAD DC PA PTAN
TXTXB114955OtherCLARK C BYROAD INDIVIDUAL PTAN
TXTXB100809OtherBRENDA KUNC BYROAD INDIVIDUAL PTAN
TXTXB114955OtherCLARK C BYROAD INDIVIDUAL PTAN