MEDICARE: DR. CLARKE D NEWMAN O.D.

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	3669TG	TX
2	152WC0802X	Corneal and Contact Management Optometrist	3669TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598753808
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLARKE D NEWMAN O.D.

Provider Business Mailing Address
First Line	:	600 N PEARL ST
Second Line	:	SUITE G-204
City	:	DALLAS
State	:	TX
Zip	:	75201-7492
Country	:	US
Telephone Number	:	214-969-0467
Fax Number	:	214-969-0468

Provider Business Practice Location Address
First Line	:	700 N PEARL ST STE N200
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75201-7428
Country	:	US
Telephone Number	:	214-969-0467
Fax Number	:	214-969-0468

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

Provider Enumeration Date	:	10/11/2005
Last Update Date	:	08/26/2021

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Directions to “ DR. CLARKE D NEWMAN O.D.” Practice Location

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