Dolores E Clark , PNP
Nurse Practitioner - Pediatrics • Grapevine, TX
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dolores Clark has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Dolores Clark, PNP was a registered Nurse Practitioner - Pediatrics practicing in Grapevine, TX. Throughout an active medical career spanning 12 years, Dolores Clark provided care at the practice location at 3801 WILLIAM D TATE AVE until profile deactivation on 2019-02-25.
Practice Location & Contact Primary Location
3801 William D Tate Ave
Ste 200
Grapevine, TX 760518755
Specialty Benchmarks & Practice Insights
Comparative analytics for Nurse Practitioner - Pediatrics in Grapevine, TX
Practicing in Grapevine, TX (2253 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 363LP0200X
Definition to come...
Practice Associates & Co-Workers
Healthcare professionals and specialists practicing at this location or sharing practice phone/fax
Counselor - Mental Health
Master of Education, Licensed Professional Counselor
Career & Practice History Timeline
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Record deactivated on February 25, 2019
NPI status registered as active in NPPES database
Registered at 3801 WILLIAM D TATE AVE, STE 200, GRAPEVINE, TX 760518755 (Tel: 8174166644)
Registered at PO BOX 99371, FORT WORTH, TX 761990371 (Tel: 6828851855)
Recorded as DOLORES CLARK, PNP
Nurse Practitioner (License #211820 in TX)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
Po Box 99371
Fort Worth, TX 761990371
Phone: 6828851855
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