MEDICARE: MRS. LISAMARIE HELEN CLARK OD

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	152W00000X	Optometrist	7523	TX

General Provider Information

NPI Number	:	1457620957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LISAMARIE HELEN CLARK OD

Provider Business Mailing Address
First Line	:	7201 BOAT CLUB RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76179-4555
Country	:	US
Telephone Number	:	817-750-2233
Fax Number	:	817-750-2266

Provider Business Practice Location Address
First Line	:	7201 BOAT CLUB RD
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76179-4555
Country	:	US
Telephone Number	:	817-750-2233
Fax Number	:	817-750-2266

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

Provider Enumeration Date	:	12/29/2011
Last Update Date	:	12/29/2011

Similar Medicare Providers

1275536005 — DR. WILLIAM LEE ASTON II O.D.
Practice Location Address:

7201 BOAT CLUB RD
FORT WORTH, TX
76179-4555

Practice Phone: 817-750-2233
Practice Fax: 817-750-2266

1548241847 — DR. ZANE A VANDIVER O.D.
Practice Location Address:

7201 BOAT CLUB RD
FORT WORTH, TX
76179-4555

Practice Phone: 817-750-2233
Practice Fax: 817-750-2266

1700971637 — DR. LORI LEIGH RUSSO O.D.
Practice Location Address:

7201 BOAT CLUB RD
FORT WORTH, TX
76179-4555

Practice Phone: 817-750-2233
Practice Fax: 817-750-2266

1558561605 — WILLIAM L ASTON OD AND MELISSA A ASTON OD PC
Practice Location Address:

7201 BOAT CLUB RD
FORT WORTH, TX
76179-4555

Practice Phone: 817-750-2233
Practice Fax: 817-750-2266

1033424932 — NIKKI SHANDELL FOX DO
Practice Location Address:

7235 BOAT CLUB RD
FT WORTH, TX
76179-4555

Practice Phone: 817-677-9535
Practice Fax: 817-677-9536

1336514835 — CTPC FORT WORTH, PLLC
Practice Location Address:

7235 BOAT CLUB RD
FORT WORTH, TX
76179-4555

Practice Phone: 817-573-9800
Practice Fax: 817-573-9821

Directions to “ MRS. LISAMARIE HELEN CLARK OD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.