MEDICARE: MRS. CLARA JOPLIN P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363AS0400X	Surgical Physician Assistant	PA10077	TX

General Provider Information

NPI Number	:	1144686452
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CLARA JOPLIN P.A.

Provider Business Mailing Address
First Line	:	106 HIGH RIDGE LN.
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75067
Country	:	US
Telephone Number	:	214-549-4178
Fax Number	:

Provider Business Practice Location Address
First Line	:	10830 N. CENTRAL EXPY. SUITE 120
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-1050
Country	:	US
Telephone Number	:	214-378-9898
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2016
Last Update Date	:	06/12/2019

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