Provider Demographics
NPI:1194610808
Name:CLARK, GARRETT LAYNE (APRN, FNP-C)
Entity type:Individual
Prefix:MR
First Name:GARRETT
Middle Name:LAYNE
Last Name:CLARK
Suffix:
Gender:M
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1845 CHELSEA BLVD APT A307
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5954
Mailing Address - Country:US
Mailing Address - Phone:903-316-3442
Mailing Address - Fax:
Practice Address - Street 1:1820 PRESTON PARK BLVD STE 1600
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-3662
Practice Address - Country:US
Practice Address - Phone:972-833-6200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-11
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1204150207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine