CHRYSTAL C CLARK (NPI# 1396104485) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396104485 |
| Entity Type | Individual |
| Full Name | CHRYSTAL C CLARK |
| Practice Address |
2200 Los Rios Blvd Suite 132 Plano TX 75074-3400 |
| Practice Telephone | 9725095070 |
| Practice Fax Number | 9725091557 |
| Mailing Telephone | 9725095070 |
| Mailing Fax Number | 9725091557 |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 1271135 | TX | Other Service Providers |
| Street Address |
2200 LOS RIOS BLVD SUITE 132 |
| City | PLANO |
| State | TX |
| Zip Code | 75074-3400 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053351379 | Floyd Scott Villines | Chiropractor | 2200 Los Rios Blvd, Suite 127, Plano, TX 75074-3400 | 2006-06-07 |
| 1124567425 | Brian R Hunter | Physical Therapist | 2200 Los Rios Blvd, Ste 132, Plano, TX 75074-3400 | 2017-02-20 |
| 1407395726 | Michael Cruz | Physical Therapist | 2200 Los Rios Blvd, Ste 132, Plano, TX 75074-3400 | 2017-02-20 |
| 1992244875 | Megan Hernandez | Physical Therapist | 2200 Los Rios Blvd, Ste 132, Plano, TX 75074-3400 | 2017-02-13 |
| 1083086235 | Theodore Gehrig IIi | Physical Therapist | 2200 Los Rios Blvd, Plano, TX 75074-3400 | 2015-10-28 |
| 1144600362 | Achieve Physical Therapy and Performance Limited Partnership | Physical Therapist | 2200 Los Rios Blvd, Suite 132, Plano, TX 75074-3400 | 2015-06-03 |
| 1245626852 | Joanna Lee | Physical Therapist | 2200 Los Rios Blvd, Suite 132, Plano, TX 75074-3400 | 2015-04-09 |
| 1831375799 | Deepika Minnal, M.d., P.a. | Pediatrics | 2200 Los Rios Blvd, Suite 128, Plano, TX 75074 | 2008-01-10 |
| 1629253265 | Villines Chiropractic, P.C. | Chiropractor | 2200 Los Rios Blvd, Suite 127, Plano, TX 75074-3400 | 2008-01-02 |
| 1710167366 | Brooke Leach | Physical Therapist | 2200 Los Rios Blvd, Ste. 132, Plano, TX 75074-3400 | 2007-11-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003433764 | All Meds Rx | Pharmacy | 2520 Avenue K, Suite 600, Suite 600, Plano, TX 75074 | 2020-06-29 |
| 1457985582 | Neighborhood Portable X-ray Services LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 6901 Avenue K Suite 109, Plano, TX 75074 | 2020-02-27 |
| 1063044113 | Q Day Walk In Clinic and Spa, LLC | Clinic/Center | 3560 East Park Blvd., Plano, TX 75074 | 2020-02-06 |
| 1891326765 | Kelly Joe Stanley | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 6901 Avenue K, 109, Plano, TX 75074 | 2020-01-30 |
| 1568016137 | Virtex Assist, Pllc | Physician Assistant | 101 E Park Blvd Suite 600, Plano, TX 75074 | 2019-07-31 |
| 1154804128 | Norte Service Providers LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 2917 Duchess Trail, Plano, TX 75074 | 2018-09-14 |
| 1386124428 | Jakayla Nekelle Price | Occupational Therapist | 3612 Kite Landing Ln., Plano, TX 75074 | 2018-08-17 |
| 1568948834 | Sarah Lindsey Binion | Counselor | 101 East Park Blvd., Suite 600, Plano, TX 75074 | 2018-07-19 |
| 1659865327 | Tim Ford | Technician, Other | 6829 Ave K, Suite 105, Plano, TX 75074 | 2018-06-18 |
| 1043708019 | Oak Point Surgical Suites LLC | Clinic/Center | 2201 K Ave Ste B-100, Plano, TX 75074 | 2018-04-25 |
| Find all providers in zip 75074 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295282531 | Lorraine M Jenkins | Specialist | 2300 Mcdermott Rd # 200-304, Plano, TX 75025-7016 | 2016-09-03 |
| 1790130573 | Brownsville Infectious Disease Pa | Specialist | 4609 Forest Park Rd, Plano, TX 75024-3906 | 2016-04-28 |
| 1174934525 | Beth V. Anglin, M.d., Pa | Specialist | 3801 W. 15th Street, Plano, TX 75075 | 2014-05-19 |
| 1861814196 | Candlewood Suites Plano East | Specialist | 2401 E President George Bush Hwy, Plano, TX 75074-8355 | 2014-01-06 |
| 1780943480 | Ranger Neurophysiology, P.a. | Specialist | 4100 15th Street, Suite 206, Plano, TX 75093-5803 | 2012-05-15 |
| 1457643207 | Theresa Lee Bradley | Specialist | 8309 Bartley Cir, Plano, TX 75025-4319 | 2011-05-12 |
| 1225367659 | Shalini Katikaneni Md Pa | Specialist | 7509 New Heart Dr, Plano, TX 75024-3973 | 2009-12-14 |
| 1700045200 | Pediatric Offices At Willow Bend | Specialist | 6529 W Plano Pkwy, Suite B, Plano, TX 75093-8209 | 2008-06-09 |
| 1568641603 | Natan Yaker | Specialist | 4100 W 15th Street, Suite 106, Plano, TX 75093 | 2007-10-25 |
| 1790970192 | Shannon Leigh Benoy | Specialist | 1901 Lake Hill Ln, Plano, TX 75023-7457 | 2007-09-09 |
| Find all providers in PLANO | ||||
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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.