Individual
ELIZABETH B CLARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
4314 KEMP BLVD, WICHITA FALLS, TX 76308
(940) 691-5645
(940) 691-5653
Mailing address
4314 KEMP BLVD, WICHITA FALLS, TX 76308-3716
(940) 691-5645
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
05108TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81141E
BCBS
TX
Enumeration date
02/20/2007
Last updated
03/10/2011
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