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General NPI Number Information
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NPI Number | 1285947903
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER A. CLARKE, M.D., P.A.
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Dates
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Enumeration Date | 07/22/2010
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Last Update Date | 07/22/2010
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Provider Practice Location Address
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Address Line | 5127 BELLERIVE DR
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City | DALLAS
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State | TX
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Zip | 75287-7551
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Country | US
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Telephone | 972-732-6945
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Fax | 972-732-6946
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Provider Business Mailing Address
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Address Line | 5127 BELLERIVE DR
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City | DALLAS
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State | TX
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Zip | 75287-7551
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Country | US
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Telephone | 972-732-6945
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Fax | 972-732-6946
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CHRISTOPHER A CLARKE
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Credential | M.D.
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Telephone | 972-569-0797
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP3000X
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Taxonomy Name | Pediatric Anesthesiology Physician
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License Number | K8731
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License Number State | TX
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