MEDICARE: CLEARVIEW PRIMARY CARE PLLC

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	363L00000X	Nurse Practitioner
2	363LA2200X	Adult Health Nurse Practitioner

General Provider Information

NPI Number	:	1700733367
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CLEARVIEW PRIMARY CARE PLLC

Provider Business Mailing Address
First Line	:	2410 LUNA RD STE 250
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75006-6575
Country	:	US
Telephone Number	:	817-300-5457
Fax Number	:	469-621-2209

Provider Business Practice Location Address
First Line	:	2410 LUNA RD STE 250
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75006-6575
Country	:	US
Telephone Number	:	817-300-5457
Fax Number	:	469-621-2209

Authorized Official
Title or Position	:	CEO
Name	:	NIDISH JOSE
Credential	:	NP
Telephone Number	:	817-300-5457

Provider Enumeration Date	:	03/12/2026
Last Update Date	:	03/12/2026

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