Individual
DR. DOUGLAS FREDRICK CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5501 B NORTH IH 35, AUSTIN, TX 78723-2430
(512) 452-5735
(512) 452-3119
Mailing address
5501 B NORTH IH 35, AUSTIN, TX 78723-2430
(512) 452-5735
(512) 452-3119
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02529TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1335416-04
—
TX
Enumeration date
06/22/2006
Last updated
06/16/2010
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