IndividualActive
Clarence Sullivan, IDMT
NPI 1437756574 · Independent Duty Medical Technicians · Fort Sam Houston, TX
Provider details
- NPI number
- 1437756574
- Entity type
- Individual
- Primary specialty
- Independent Duty Medical TechniciansOther Service Providers
- Credential
- IDMT
- Sex
- Male
- Sole proprietor
- No
Specialties & taxonomies
Other Service Providers
Practice location
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Phone: (210) 916-3918
Approximate (ZIP-level) locationGet directions
Mailing address
3551 Roger Brooke Dr
Fort Sam Houston, TX 78234-4504
Registry dates
- Enumerated
- 2020-10-01
- Last updated
- 2020-10-01
- Certified
- 2020-10-01
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.