Provider Demographics
NPI:1043264799
Name:CLARK, LISA HARPER (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:HARPER
Last Name:CLARK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8220 WALNUT HILL LN
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4427
Mailing Address - Country:US
Mailing Address - Phone:214-739-0772
Mailing Address - Fax:214-987-3194
Practice Address - Street 1:8220 WALNUT HILL LN
Practice Address - Street 2:110
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4427
Practice Address - Country:US
Practice Address - Phone:214-739-0772
Practice Address - Fax:214-987-3194
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2010-11-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXG2930207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine