Individual
DR. EMMETTE A CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
460 HIDDEN LAKE DR, PROSPER, TX 75078-8784
(972) 346-2300
(972) 346-2300
Mailing address
460 HIDDEN LAKE DR, PROSPER, TX 75078-8784
(972) 346-2300
(972) 346-2300
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
E6052
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8AL507
BCBS
TX
Enumeration date
03/02/2006
Last updated
05/16/2016
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