Individual
DR. CARLTON KEITH CLARKE II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
407 W I 30, GARLAND, TX 75043-5912
(972) 303-2222
(972) 303-2220
Mailing address
407 W INTERSTATE 30, GARLAND, TX 75043-5912
(972) 303-2222
(972) 303-2220
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
L4890
TX
207QA0401X
Addiction Medicine (Family Medicine) Physician
L4890
TX
207QA0505X
Adult Medicine Physician
L4890
TX
207QG0300X
Geriatric Medicine (Family Medicine) Physician
L4890
TX
207R00000X
Internal Medicine Physician
L4890
TX
207V00000X
Obstetrics & Gynecology Physician
Primary
L4890
TX
208D00000X
General Practice Physician
L4890
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1529026-01
—
TX
Enumeration date
07/28/2005
Last updated
02/01/2016
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