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General NPI Number Information
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NPI Number | 1700733367
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Entity Type | Organization
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Legal Business Name | CLEARVIEW PRIMARY CARE PLLC
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Dates
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Enumeration Date | 03/12/2026
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Last Update Date | 03/12/2026
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Provider Practice Location Address
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Address Line | 2410 LUNA RD STE 250
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City | CARROLLTON
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State | TX
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Zip | 75006-6575
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Country | US
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Telephone | 817-300-5457
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Fax | 469-621-2209
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Provider Business Mailing Address
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Address Line | 2410 LUNA RD STE 250
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City | CARROLLTON
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State | TX
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Zip | 75006-6575
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Country | US
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Telephone | 817-300-5457
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Fax | 469-621-2209
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Authorized Official
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Title or Position | CEO
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Name | NIDISH JOSE
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Credential | NP
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Telephone | 817-300-5457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number |
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License Number State |
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