Calvin S Clarke, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

02116T Issued in TX

Practice address

4314 Kemp Blvd
Wichita Falls, TX 76308

Phone

(940) 691-5645

Fax

(940) 691-5653

NPI assigned

Feb 20, 2007

Last updated

Mar 10, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299715200000",
    "number": "1629113345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4314 KEMP BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "76308",
            "telephone_number": "940-691-5645"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4314 KEMP BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "76308",
            "telephone_number": "940-691-5645",
            "fax_number": "940-691-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARKE",
        "first_name": "CALVIN",
        "middle_name": "S",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-20",
        "last_updated": "2011-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "02116T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "81139E",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clark Colville and Kelly Heetland Specialty Partners of Texas PLLC (Heetland and Heetland Orthodontics)
• Heather Clark, MD
• Melissa Clark, LVN
• Nicole Lee Clark
• Clarke Eyecare Center, LLP (Clarke EyeCare Center)
• Daniel B Clarke, OD
• Elizabeth B Clarke, OD
• Gracie Clarke, LCSW
• Thomas J Cleary, LCSW
• Allison E Clement, PTA

• Optometrist in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.