Individual
DAVID B CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
911 23RD ST, CANYON, TX 79015-4600
(806) 655-2104
(806) 655-0522
Mailing address
911 23RD ST, CANYON, TX 79015-4600
(806) 655-2104
(806) 655-0522
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
J4047
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
092485403
—
TX
01
—
132153100
FIRST CARE
TX
05
—
138727615
—
TX
01
—
8G5850
BCBS
TX
Enumeration date
08/11/2006
Last updated
11/06/2015
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