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C CLARKE II MD GYN PA NPI 1174785042


NPI Information

NPI: 1174785042
Provider Name: C CLARKE II MD GYN PA

Doing Business As: CARLTON K CLARKE II MD

Classification: Clinic/Center - 261QM2500X
Entity Type: Organization

Specialization: Medical Specialty

Address:
407 W I 30
GARLAND, TX
ZIP 75043
Phone: (972) 303-2222
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C CLARKE II MD GYN PA is a medical specialty clinic center in Garland, TX. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). C CLARKE II MD GYN PA NPI is 1174785042. The provider is registered as an organization entity type.
The provider Is Doing Business As Carlton K Clarke Ii Md.

The provider's business location address is:

407 W I 30
GARLAND, TX
ZIP 75043-912
Phone: (972) 303-2222
Fax: (972) 303-2220

The provider's authorized official is Carlton Keith Clarke .
The authorized official title is Physician / Owner and has the following contact phone number (214) 316-0913.

The enumeration date for this NPI number is 7/1/2008 and was last updated on 3/6/2009.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QM2500XClinic/CenterMedical SpecialtyL4890TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11529026-01MEDICAIDTEXAS
2H78235MEDICARE UPINTEXAS
300548HOTHERTEXASOB/GYN SPECIALTY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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