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Individual

GERALD P CLARKE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3410 FAR WEST BLVD STE 140, AUSTIN, TX 78731-3167
(512) 427-1100
(512) 427-1207
Mailing address
3410 FAR WEST BLVD STE 140, AUSTIN, TX 78731-3167
(512) 427-1100
(512) 427-1207

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
21638-020
WI
207W00000X
Ophthalmology Physician
Primary
U9495
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30380600
WI
Enumeration date
12/15/2006
Last updated
05/14/2024
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