Clyde C Clybourn MD PA

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

M7914 Issued in TX

Legal business name

CLYDE C CLYBOURN MD PA

Practice address

2705 Hospital Dr
Suite 212
Victoria, TX 77901-5775

Phone

(361) 574-1895

NPI assigned

Jun 5, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Clyde Clybourn, MD

Title

Owner/Provider

Phone

(302) 242-2399

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213920000000",
    "number": "1689833600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2705 HOSPITAL DR",
            "address_2": "SUITE 212",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015775",
            "telephone_number": "361-574-1895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2705 HOSPITAL DR",
            "address_2": "SUITE 212",
            "city": "VICTORIA",
            "state": "TX",
            "postal_code": "779015775",
            "telephone_number": "361-574-1895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLYDE C CLYBOURN MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2008-06-20",
        "status": "A",
        "authorized_official_last_name": "CLYBOURN",
        "authorized_official_first_name": "CLYDE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "302-242-2399",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M7914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• City of Victoria
• Elizabeth Frances Clapp, AG-ACNP
• Kynsey Clark
• Claudia Amador, PLLC
• Andrew Charles Clemmons, D.O.
• Coastal Transportation Services Inc.,
• Jason Cochrum
• Gloria Anne Coffey, LPC
• Tamarah K Coffey, R.N., P.N.P
• Olivia Anne Cole, LPC

• Internal Medicine Physician in Victoria, TX
• Providers in Victoria, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.