Provider Demographics
NPI:1699167171
Name:BUOL, CLINTON
Entity type:Individual
Prefix:
First Name:CLINTON
Middle Name:
Last Name:BUOL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 SUNDOWN BLVD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-8032
Mailing Address - Country:US
Mailing Address - Phone:940-387-3700
Mailing Address - Fax:940-488-4513
Practice Address - Street 1:3301 SUNDOWN BLVD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210
Practice Address - Country:US
Practice Address - Phone:940-387-3700
Practice Address - Fax:940-488-4513
Is Sole Proprietor?:No
Enumeration Date:2015-02-20
Last Update Date:2019-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3116730225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist