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General NPI Number Information
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NPI Number | 1992789713
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Entity Type | Individual
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Provider Name | BURNET TODD CLARKE MD
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Gender | Male
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Dates
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Enumeration Date | 12/05/2005
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Last Update Date | 08/06/2025
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Provider Practice Location Address
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Address Line | 3460 N. DOWLEN RD
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City | BEAUMONT
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State | TX
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Zip | 77706-1690
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Country | US
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Telephone | 409-838-0346
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Fax | 409-839-3720
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Provider Business Mailing Address
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Address Line | 3460 N. DOWLEN RD
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City | BEAUMONT
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State | TX
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Zip | 77706-1690
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Country | US
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Telephone | 409-838-0346
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Fax | 409-839-3720
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | H9851
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License Number State | TX
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