NPIMap

Organization Active NPI

Clarke Eyecare Center, LLP

  • Optometrist
  • Wichita Falls, TX
National Provider Identifier
1730398306
Registry record updated Mar 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
5108TG Issued in TX
Legal business name
CLARKE EYECARE CENTER, LLP
Practice address
4314 Kemp Blvd
Wichita Falls, TX 76308-3716
Phone
(940) 691-5645
Fax
(940) 691-5653
NPI assigned
May 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2011

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

Authorized official

Name
Dr. Daniel B. Clarke, O.D.NPI 1689719098
Title
Owner
Phone
(940) 691-5645

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 2116T TX
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 5107TG TX
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 5108TG TX Primary

Addresses

Primary practice location

4314 Kemp Blvd
Wichita Falls, TX 76308-3716

Mailing address

4314 Kemp Blvd
Wichita Falls, TX 76308-3716
Phone (940) 691-5645

Other names 1

  • Clarke EyeCare Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090616000125 TX Part B Supplier - Clinic/Group Practice 1052461944 Receives reassigned benefits from 6 practitioners
Practice locations: Burkburnett, TX; Wichita Falls, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2028036Clarke Eyecare Center4314 Kemp Blvd, Wichita Falls, TX 76308Certificate of waiverAug 7, 2027

National Provider Directory

National Provider Directory

Locations

902 W Kramer Rd
Burkburnett, TX 76354
Phone (940) 569-4131

2201 Paradise St
Vernon, TX 76384
Phone (940) 553-4328

4314 Kemp Blvd
Wichita Falls, TX 76308
Phone (940) 691-5645

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299715200000",
    "number": "1730398306",
    "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": "763083716",
            "telephone_number": "940-691-5645",
            "fax_number": "940-691-5653"
        },
        {
            "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": "763083716",
            "telephone_number": "940-691-5645",
            "fax_number": "940-691-5653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKE EYECARE CENTER, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2011-03-10",
        "status": "A",
        "authorized_official_last_name": "CLARKE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "940-691-5645",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2116T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5107TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "5108TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clarke EyeCare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wichita Falls, TX

Sources for this page

  • 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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.