# KLARISANA PHYSICIAN SERVICES PLLC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KLARISANA PHYSICIAN SERVICES PLLC
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1902418965
- **Legal business name:** KLARISANA PHYSICIAN SERVICES PLLC
- **Authorized official:** DR. CARL JOHN BONNETT MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (303) 535-7548

## Contact information

- **Practice address:** 9195 GRANT ST STE 130, THORNTON, CO 80229-4348
- **Practice address phone:** (303) 535-7548
- **Mailing address:** PO BOX 736403, DALLAS, TX 75373-6403
- **Mailing address phone:** (303) 535-7548
- **Mailing address fax:** (888) 504-2390

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |
| 261Q00000X | Clinic/Center | — | NULL | Yes |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 261QP3300X | Pain Clinic/Center | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | — |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 08/20/2020
- **Last updated:** 10/06/2026