Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Desraj Clark

Individual provider Military Health Care Provider · NPI 1396109666

Desraj Clark is a Military Health Care Provider in Fort Bliss, Texas. Licensed in Nebraska. Registered with an NPI since 2016.

Licensed in
NE
In the registry since
2016
Specialties on file
3

Practice location Address checks out

18511 Highlander Medics St
Fort Bliss, TX 79906-5327
Phone: (915) 742-0353
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopaedic Surgery Physician (primary) Taxonomy 207X00000X · Licence 30773 (NE)
Military Health Care Provider Taxonomy 171000000X
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1396109666
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedApril 12, 2016
Last updated in NPPESOctober 30, 2023
Certification dateOctober 30, 2023
Mailing address18511 Highlander Medics St, Fort Bliss, TX 79906-5327

Other providers in Fort Bliss