CHARLES PATRICK CLARK (NPI# 1760940753) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760940753 |
| Entity Type | Individual |
| Full Name | CHARLES PATRICK CLARK |
| Credential | PA-C |
| Practice Address |
6621 Fannin St, Houston Houston TX 77030 |
| Mailing Address |
548 W 27th St Houston TX 77008-1910 |
| Practice Telephone | 8653138431 |
| Mailing Telephone | 8653138431 |
| Enumeration Date | 2019-03-08 |
| Last Update Date | 2019-03-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013485713 | Charles Nicholson Clark | Nurse Practitioner | 1331 Bandera Hwy Ste 4, Kerrville, TX 78028-9535 | 2018-11-12 |
| 1568971653 | Charles E Clark IIi | Counselor | 255 Main Street, St. Clairsville, OH 43950 | 2017-09-21 |
| 1649680406 | Charles Amos Clark | Internal Medicine | Vanderbilt University Dept of Medicine, D-3100, Medical Center North, Nashville, TN 37232 | 2014-05-02 |
| 1124301106 | Charles Malcolm Clark Jr. | Internal Medicine | 2802 Lafayette Road Suite 13, Eagledale Health Center, Indianapolis, IN 46222-2112 | 2011-09-26 |
| 1811290935 | Charles Warren Clark Jr. | Massage Therapist | 19577 Fm 2854 Rd, Montgomery, TX 77316-3150 | 2010-12-11 |
| 1780913640 | Charles S Clark | Physician Assistant | Bldg. H 2005 Knight Lane Attn: Medical Staff Services, Navy Medicine Support Command, Jacksonville, FL 92055-0140 | 2009-12-23 |
| 1083866222 | Charles Larry Clark Jr. | Dentist | 2415 Gillionville Rd, Albany, GA 31707-3022 | 2008-10-21 |
| 1689826984 | Charles John Clark | Pharmacist | 203 So. Daisy, Salmon, ID 83467 | 2008-10-17 |
| 1164642948 | Charles Robert Clark | Family Medicine | 1725 N Sky Glen Path, Hernando, FL 34442-6187 | 2007-04-26 |
| 1093722902 | Charles Kevin Clark | Physical Therapist | 10214 N Tatum Blvd, Suite B-500, Phoenix, AZ 85028-4224 | 2006-08-02 |
| Street Address |
6621 FANNIN ST, HOUSTON |
| City | HOUSTON |
| State | TX |
| Zip Code | 77030 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639770852 | Mchaji Celestaine | Pharmacist | Medvamc 2002 Holcombe Blvd, Outpatient Pharmacy, Houston, TX 77030 | 2020-11-04 |
| 1730702598 | Christopher A Mcmillian | Student in an Organized Health Care Education/Training Program | Houston Methodist Department of Surgery, 6550 Fannin St., Smith Tower 1661, Houston, TX 77030 | 2020-05-27 |
| 1245852698 | Mostafa Hotait | Student in an Organized Health Care Education/Training Program | 7200 Cambridge Street 9a, Houston, TX 77030 | 2020-05-08 |
| 1790307288 | Ayushi Jayesh Shah | Student in an Organized Health Care Education/Training Program | 6560 Fannin St, Department of Neurology, Houston Method, Suite 802, Scurlock. 8thfloor, Houston, TX 77030 | 2020-05-07 |
| 1932720836 | Vera Whole Health Wa, PC | Clinic/Center | 6620 Main St, 12th Flr, Ste 1225, Houston, TX 77030 | 2020-05-01 |
| 1548881808 | Mobitz Heart and Rhythm Center Pllc | Internal Medicine | Scurlock Tower, 6560 Fannin St., Houston, TX 77030 | 2020-04-28 |
| 1710516513 | Thomas Chi Han Lu | Student in an Organized Health Care Education/Training Program | 6431 Fannin Street, Msb 3.151, Houston, TX 77030 | 2020-04-03 |
| 1063041085 | Kevin Tang | Student in an Organized Health Care Education/Training Program | 7200 Cambridge., Bcm 903, Suite A10.202, Houston, Texas, TX 77030 | 2020-04-02 |
| 1831728898 | Taylor Renbarger | Student in an Organized Health Care Education/Training Program | 6431 Fannin St Suite Jjl 431, Houston, TX 77030 | 2020-04-02 |
| 1972131423 | Sindhu R Rao | Student in an Organized Health Care Education/Training Program | 7200 Cambridge Street, 9th Floor, Suite 9a, Houston, TX 77030 | 2020-03-31 |
| Find all providers in zip 77030 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710524103 | R & H Surgical Services, LLC | Physician Assistant | 14507 Parkesgate Dr, Houston, TX 77083-5792 | 2019-12-04 |
| 1639711195 | Landry & Kiejna Surgical Assisting | Physician Assistant | 1120 Business Center Dr Ste 110, Houston, TX 77043-2735 | 2019-10-16 |
| 1619526563 | Uma Surgical Assistant Services, LLC. | Physician Assistant | 4517 Benning Dr, Houston, TX 77035-6005 | 2019-09-04 |
| 1417503467 | Superior Surgical Services, LLC | Physician Assistant | 5527 Yorkwood St, Houston, TX 77016 | 2019-08-15 |
| 1558829598 | Charlotte Peeters | Physician Assistant | 6621 Fannin St Ste D0600.33, Houston, TX 77030-2358 | 2019-03-08 |
| 1689148702 | Erin Danielle Schulte | Physician Assistant | 3 Hermann Museum Circle Dr Apt 4414, Houston, TX 77004-7969 | 2019-01-12 |
| 1972074532 | Nationwide Surgical Resources LLC | Physician Assistant | 7600 Burgoyne Rd Unit 207, Houston, TX 77063-3104 | 2018-12-07 |
| 1891264446 | Taylor K Rubin | Physician Assistant | 1140 Business Center Dr Ste 101, Houston, TX 77043-2740 | 2018-11-13 |
| 1679049522 | Jacob Paul Landry | Physician Assistant | 18108 S Parkview Dr Apt I17, Houston, TX 77084-6578 | 2018-10-18 |
| 1164904645 | Jb Surgical Inc | Physician Assistant | 12955 Willow Place Dr W # 691789, Houston, TX 77070-5651 | 2018-08-31 |
| Find all providers in HOUSTON | ||||
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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.