CLARENCE MICHAEL SULLIVAN IDMT
NPI 1437756574
Military Health Care Provider - Independent Duty Medical Technicians in Fort Sam Houston, TX

Active since October 01, 2020
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234(210) 916-3918 Get Directions Write a Review

NPPES record last updated: October 1, 2020. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Clarence Michael Sullivan Idmt NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CLARENCE MICHAEL SULLIVAN IDMT (NPI 1437756574) is an individual independent duty medical technicians provider in Fort Sam Houston, Texas and active in the NPI registry since October 2020.

NPPES Registry Identity

NPI1437756574
Entity TypeIndividualMale
Primary Taxonomy1710I1003X
Provider Legal NameCLARENCE MICHAEL SULLIVANCredential: IDMT
Location Address3551 ROGER BROOKE DRFort Sam Houston, TX 78234-4504
Mailing Address3551 Roger Brooke DrFort Sam Houston, TX 78234-4504
Sole ProprietorNo
Enumeration DateOctober 1, 2020
NPPES CertifiedOctober 1, 2020
NPI 1437756574 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code1710I1003X
Definition
An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
3551 ROGER BROOKE DR, Fort Sam Houston, TX 78234

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Anesthetist, Certified Registered
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Physician Assistant
3551 ROGER BROOKE DR
JBSA FT SAM HOUSTON, TX 78234
Pediatrics (Pediatric Endocrinology)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Social Worker (Clinical)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Neurological Surgery
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Social Worker (Clinical)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234
Ophthalmology
3551 ROGER BROOKE DR
JBSA FORT SAM HOUSTON, TX 78234
Emergency Medicine (Emergency Medical Services)
3551 ROGER BROOKE DR
FORT SAM HOUSTON, TX 78234

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Clarence Sullivan's NPI number?

The NPI number for Clarence Sullivan is 1437756574. It was assigned to this individual provider in the NPPES registry on October 1, 2020.

Where is Clarence Sullivan located?

Clarence Sullivan practices at 3551 Roger Brooke Dr, Fort Sam Houston, TX 78234. The listed phone number is (210) 916-3918.

What is Clarence Sullivan's specialty?

The primary specialty registered for this NPI is Military Health Care Provider, specializing in Independent Duty Medical Technicians, with taxonomy code 1710I1003X.

When was this NPI record last updated?

The NPPES record for Clarence Sullivan was last updated on October 1, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.