Clark, David Roger
Clark, David Roger is an sole proprietor health care provider with primary practice located at 2812 Millbrook Ct , Arlington TX 76012-2116. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Clark, David Roger can be contacted via phone (817) 860-4393.Contact Information
Primary practice address
2812 Millbrook Ct
Arlington TX 76012-2116
Phone: (817) 860-4393
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | E3162 | Texas |
Profile Details
| NPI number | 1306059480 |
|---|---|
| LBN Legal business name | Clark, David Roger |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 7th, 2007 |
| Last updated | Jul 11th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306059480 | NPPES |
| Texas | MEDICAID | P000AB990 |
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