DR. CLARK ALEXANDER WILSON (NPI# 1083963334) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1083963334 |
Entity Type | Individual |
Full Name | DR. CLARK ALEXANDER WILSON |
Credential | MD |
Practice Address |
901 W 38th St Ste 200 Austin TX 78705-1165 |
Mailing Address |
Po Box 911230 Dallas TX 75391-1230 |
Practice Telephone | 5124214235 |
Mailing Telephone | 9729978000 |
Mailing Fax Number | 9722342987 |
Enumeration Date | 2012-09-02 |
Last Update Date | 2020-08-14 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 208800000X | Urology | 35.135944 | OH | Allopathic & Osteopathic Physicians |
Y | 208800000X | Urology | Q7812 | TX | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
TX | 387365502 | 05 | |
TX | 387365503 | 05 |
Street Address |
901 W 38TH ST STE 200 |
City | AUSTIN |
State | TX |
Zip Code | 78705-1165 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124089412 | Christopher Owen Ruud | Internal Medicine | 901 W 38th St Ste 200, Austin, TX 78705-1165 | 2006-03-28 |
1851865042 | Chelsea Crilly | Nurse Practitioner | 901 W 38th St Ste 200, Austin, TX 78705-1165 | 2019-01-22 |
1215438452 | Mary Jane Berry | Nurse Practitioner | 901 W 38th St Ste 200, Austin, TX 78705-1165 | 2018-02-22 |
1821598848 | Hannah Astrid-brooke Culver | Physician Assistant | 901 W 38th St Ste 200, Austin, TX 78705-1165 | 2018-02-16 |
1467744391 | Athira Unnikrishnan | Internal Medicine | 901 W 38th St Ste 200, Austin, TX 78705-1165 | 2011-05-11 |
1992952659 | Heather Merceir King | Surgery | 901 W 38th St Ste 200, Austin, TX 78705-1165 | 2008-08-25 |
1396910899 | Kathryn Long Stone | Clinical Nurse Specialist | 901 W 38th St Ste 200, Southwest Regional Cancer Center, Austin, TX 78705-1165 | 2008-04-25 |
1700909744 | Andrew Jacob Brenner | Internal Medicine | 901 W 38th St Ste 200, Austin, TX 78705 | 2007-04-06 |
1184775231 | Rebecca Fisher | Psychiatry & Neurology | 901 W 38th St Ste 200, Austin, TX 78705-1165 | 2007-01-16 |
1467545004 | Morris D. Groves Jr. | Psychiatry & Neurology | 901 W 38th St Ste 200, Austin, TX 78705-1165 | 2006-10-02 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1740894559 | Ben Aviel | Specialist/Technologist | 2501 Leon, Austin, TX 78705 | 2020-08-31 |
1700408739 | Julie Marie Dorland | Obstetrics & Gynecology | Ut Austin Dell Medical School Obgyn Medical Park Tower, 1301 W 38th St, Suite 705, Austin, TX 78705 | 2020-05-13 |
1952941155 | Oluwakemi Yemi-ese | Counselor | 2717 Rio Grande Street, Austin, TX 78705 | 2020-01-15 |
1285272765 | Lisa K Wheeler | Counselor | 2520 Longivew Street, Suite 313, Austin, TX 78705 | 2019-12-16 |
1033767637 | Olivia May Neel | Specialist/Technologist | 620 West 24th Street, 208a, Austin, TX 78705 | 2019-08-28 |
1336795202 | Grace Evelyn Martin | Specialist/Technologist | University of Texas, 110 Inner Campus Drive, Austin, TX 78705 | 2019-08-15 |
1801450317 | Nicole Buchele | Obstetrics & Gynecology | Ut Austin Dell Medical School-obgyn, Medical Park Tower, 1301 W 38th St, Suite 705, Austin, TX 78705 | 2019-04-30 |
1124502794 | Joan Margaret Carroll | Physician Assistant | 3000 N, I-35, Suite 600, Austin, TX 78705 | 2018-09-19 |
1841797636 | Corbin Anne Weaver | Obstetrics & Gynecology | Medical Park Tower, 1301 W. 38th St., Suite 705, Austin, TX 78705 | 2018-04-09 |
1740707892 | Christine Marie Falk | Specialist/Technologist | 2810 Hemphill Park, Apt 211, Austin, TX 78705 | 2017-08-29 |
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Taxonomy Code | 208800000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Urology |
A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215443064 | Greater Austin Urology, Pllc | Urology | 11673 Jollyville Rd Ste B101, Austin, TX 78759 | 2017-12-15 |
1366853152 | Lawrence Tsai | Urology | 12319 N Mopac Expy Ste 200, Austin, TX 78758-2497 | 2014-05-14 |
1558780031 | Rachel Sosland | Urology | 4207 James Casey St Ste 107, Austin, TX 78745-1192 | 2014-04-10 |
1457676215 | Kelly Jeanne Nast | Urology | 1301 Barbara Jordan Blvd Ste 302, Austin, TX 78723-3078 | 2010-04-05 |
1477795458 | Edward Charles Osterberg IIi | Urology | 1400 North Interstate 35 Frontage Rd, Suite Cl 300, Austin, TX 78701-1996 | 2009-04-06 |
1245497387 | Danielle Dienert Sweeney | Urology | 916 Springdale Rd Bldg 5-102, Austin, TX 78702 | 2008-05-16 |
1023100492 | J Stuart Wolf Jr. | Urology | 1400 Barbara Jordan Blvd Ste 1.114, Mailcode R1800, Austin, TX 78723-3092 | 2006-09-29 |
1982601274 | Jeffrey Neal Kocurek | Urology | 1301 W 38th St, Ste. #200, Austin, TX 78705-1000 | 2005-07-01 |
1083618706 | Joy Nielsen | Urology | 12221 N Mo Pac Expy, Austin, TX 78758-2401 | 2005-06-10 |
1548262728 | Jose Carlos Cortez | Urology | 1301 Barbra Jordan Blvd., Suite 302, Austin, TX 78723-3078 | 2005-06-01 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.