MICHAEL G CLARK (NPI# 1326006834) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326006834 |
| Entity Type | Individual |
| Full Name | MICHAEL G CLARK |
| Credential | PA |
| Practice Address |
1305 Airport Fwy Ste 305 Bedford TX 76021-6604 |
| Practice Telephone | 8175451355 |
| Practice Fax Number | 8175451574 |
| Mailing Telephone | 8175451355 |
| Mailing Fax Number | 8175451574 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2012-03-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA00339 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 196349804 | 05 | |
| TX | 196349802 | 05 | |
| TX | 196349801 | 05 | |
| TX | BCBS | 8N2840 | 01 |
| TX | 196349803 | 05 | |
| TX | RAILROAD MEDICARE | P00297373 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215534227 | Michael Clark | Contractor | 1107 Lavender Shade Court, Houston, TX 77073 | 2020-10-02 |
| 1558858464 | Michael Clark | Optometrist | 990 Medical Dr Ste G3, Brigham City, UT 84302 | 2018-04-16 |
| 1740780006 | Michael Ryan Clark | Pharmacist | 556 Northside Drive, Statesboro, GA 30458 | 2018-02-13 |
| 1942715255 | Michael Clark | Physical Medicine & Rehabilitation | 10600 Riverside Drive, Coral Springs, FL 33071-3307 | 2017-12-08 |
| 1386170348 | Michael Clark | Registered Nurse | 317 E 100 N, Price, UT 84501-2504 | 2017-05-11 |
| 1184163982 | Michael Clark | Specialist/Technologist | 19 Second Ave, Auburn, NY 13021-5113 | 2017-02-14 |
| 1356780837 | Michael Clark | Adult Companion | 8305 Concord Dr, Rowlett, TX 75089-2001 | 2013-06-18 |
| 1417394503 | Michael Ray Clark | Pharmacist | 2661 Valleydale Rd, Hoover, AL 35244-2026 | 2013-05-29 |
| 1407143381 | Michael Jeffery Clark | Orthopaedic Surgery | 5671 Peachtree Dunwoody Ste 700, Atlanta, GA 30342-5047 | 2011-06-29 |
| 1700183993 | Michael Brady Clark | Preventive Medicine | 1400 Mckean Rd, Spring House, PA 19477 | 2011-02-24 |
| Street Address |
1305 AIRPORT FWY STE 305 |
| City | BEDFORD |
| State | TX |
| Zip Code | 76021-6604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396357851 | Crystal Le | Pharmacist | 4121 E Hardwood Rd, Bedford, TX 76021 | 2020-08-17 |
| 1114544095 | Morgan Sanders | Physical Therapist | 2419 Tx 121, Bedford, TX 76021 | 2020-06-26 |
| 1669938171 | Tracie Thomas | Nurse Practitioner | 3901 Airport Freeway, Suite 230, Bedford, TX 76021 | 2019-02-20 |
| 1346710928 | Bedford Pharmacy LLC | Pharmacy | 2816 Central Dr Ste 160, Bedford, TX 76021 | 2018-11-27 |
| 1861973562 | Healogix Consultants, LLC | Pharmacy | 601-1 Harwood Rd, Bedford, TX 76021 | 2018-08-22 |
| 1851870570 | Artie Lee Nolen | Licensed Vocational Nurse | 1415 Shady Ln, Bedford, TX 76021 | 2018-08-13 |
| 1821510496 | Gabriela D Driskill | Counselor | 201 E. 9th Street, Dallas, TX 76021 | 2017-07-14 |
| 1588190938 | Tdc-bedford Dialysis Clinic LLC | Clinic/Center | 725 N Industrial Blvd, Ste 100, Bedford, TX 76021 | 2017-05-04 |
| 1801246673 | Tamara Allen-wolf, LLC | Counselor | 2217 Martin Dr., Ste 200, Bedford, TX 76021 | 2016-06-13 |
| 1013399799 | Nirvana Dental | Clinic/Center | 3704 Cheek Sparger Road #100, Bedford, TX 76021 | 2015-06-18 |
| Find all providers in zip 76021 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538650650 | Bluestone Healthcare Services L.L.C. | Physician Assistant | Bluestone Healthcare Services LLC 169 South River Rd, Bedford, NH 03103 | 2018-05-24 |
| 1336652833 | Alyssa Ilg | Physician Assistant | 1615 Hospital Pkwy Ste 306, Bedford, TX 76022-5936 | 2017-11-07 |
| 1023334562 | Joseph Mangum | Physician Assistant | 5 Washington Place, Suite 1b, Bedford, NH 03110 | 2010-04-08 |
| 1033358759 | Christopher G. Carter | Physician Assistant | 7 Pinewood Ter, Bedford, NH 03110-5537 | 2009-02-19 |
| 1851416986 | Deanne Marie Chapman | Physician Assistant | 20 Washington Pl Fl 2, Bedford, NH 03110-6706 | 2007-03-20 |
| 1780736777 | Ronald E Ochoa | Physician Assistant | 88 Center Rd Ste 360, Bedford, OH 44146-2711 | 2007-01-18 |
| 1811937113 | Leah Ann Franks | Physician Assistant | 1368 American Way, Bedford, VA 24523-2940 | 2006-06-07 |
| 1740265560 | Kirstin Dawn Pickens | Physician Assistant | 2425 Hwy 121, Bedford, TX 76021 | 2005-12-14 |
| 1861053241 | Morgan Copeland | Physician Assistant | 1701 Park Place Ave, Bedford, TX 76022-6033 | 2019-06-26 |
| 1871154179 | Brenna R. Erzen | Physician Assistant | 4 Hawthorne Dr, Bedford, NH 03110-6983 | 2019-06-26 |
| Find all providers in BEDFORD | ||||
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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.