DR. CHARLES B. CLARK III (NPI# 1770689358) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770689358 |
| Entity Type | Individual |
| Full Name | DR. CHARLES B. CLARK III |
| Credential | M.D. |
| Practice Address |
6025 Metropolitan Dr Suite 205 Beaumont TX 77706-2408 |
| Practice Telephone | 4098994999 |
| Practice Fax Number | 4098993978 |
| Mailing Telephone | 4098994999 |
| Mailing Fax Number | 4098993978 |
| Enumeration Date | 2006-09-15 |
| Last Update Date | 2015-03-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | D9396 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | MEDICARE PTAN | 359865 | 01 |
| TX | 0981946-01 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760940753 | Charles Patrick Clark | Physician Assistant | 6621 Fannin St, Houston, Houston, TX 77030 | 2019-03-08 |
| 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 |
| Street Address |
6025 METROPOLITAN DR SUITE 205 |
| City | BEAUMONT |
| State | TX |
| Zip Code | 77706-2408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760482640 | Erwin Lo | Specialist | 6025 Metropolitan Dr, Suite 205, Beaumont, TX 77706-2407 | 2005-07-21 |
| 1679954168 | Metropolitanc Drive Medical Center | Surgery | 6025 Metropolitan Dr, 205a, Beaumont, TX 77706-2407 | 2015-06-10 |
| 1477971489 | Leah Renee Moreau | Nurse Practitioner | 6025 Metropolitan Dr, Suite 210, Beaumont, TX 77706-2407 | 2014-04-07 |
| 1881027779 | Texas Neurocare and Spine Institiute Pllc | Psychiatry & Neurology | 6025 Metropolitan Dr, Suite 200, Beaumont, TX 77706-2407 | 2013-08-14 |
| 1265865158 | Brain and Spine Center of Southeast Texas, Pllc | Psychiatry & Neurology | 6025 Metropolitan Dr, Suite 205, Beaumont, TX 77706-2407 | 2013-08-14 |
| 1346417342 | Beaumont Neurosurgical Spine Associates Pa | Neurological Surgery | 6025 Metropolitan Dr, Suite 205, Beaumont, TX 77706-2408 | 2008-05-09 |
| 1710987672 | Sujin Yu | Specialist | 6025 Metropolitan Dr, Suite 205, Beaumont, TX 77706-2407 | 2005-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982176293 | Allen Family Home Care LLC | In Home Supportive Care | 4055 Dowlen Rd Ste 112, Beaumont, TX 77706 | 2018-12-27 |
| 1730661174 | Joseph Pryor Ingram | Counselor | 5450 Folsom Road #3, Beaumont, TX 77706 | 2018-09-02 |
| 1336644582 | Jenny Lee Broaddus | Counselor | 8150 N. Major Dr., Beaumont, TX 77706 | 2018-03-29 |
| 1528584026 | Amanthia Peace Williams | Pedorthist | 3645 Calder Ave., Beaumont, TX 77706 | 2017-08-16 |
| 1356863286 | Nicole Denise Williams | Speech-Language Pathologist | 970 North 23rd Street, Beaumont, TX 77706 | 2017-07-12 |
| 1487038923 | Associates for Dental Health, Pllc | Dentist | 415 Dowlen Rd Ste A, Beaumont, TX 77706 | 2015-07-15 |
| 1508264532 | Rose Anne Essex | Dietitian, Registered | 3510 Charleston Ln, Beaumont, TX 77706 | 2014-12-08 |
| 1780001933 | C. Asteris, Inc. | Contractor | 1465 W. Lucas Dr., Beaumont, TX 77706 | 2014-03-26 |
| 1376985820 | Erica J Hayes M D P A | Preferred Provider Organization | 4a Bayou Brandt Drive, Beaumont, TX 77706 | 2013-07-25 |
| 1194162909 | Hezron Omanga | Pharmacist | 3585 N. Dowlen Road, Beaumont, TX 77706 | 2013-06-03 |
| Find all providers in zip 77706 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104824671 | Tamerla Dawn Chavis | Neurological Surgery | 755 N 11th Street, Suite P5500, Beaumont, TX 77702 | 2005-07-08 |
| 1841687522 | Fernando E Silva, Md, Pa | Neurological Surgery | 2965 Harrison St, Ste 111, Beaumont, TX 77702-1186 | 2015-04-21 |
| 1386982528 | Nader Consultants LLC | Neurological Surgery | 3070 College St, Suite 100, Beaumont, TX 77701-4691 | 2013-01-23 |
| 1306102439 | Tamerla D Chavis Md,pa | Neurological Surgery | 755 N 11th St, Suite P-5500, Beaumont, TX 77702-1500 | 2012-04-03 |
| 1588934996 | Texas Center for Neurosciences Pllc | Neurological Surgery | 3070 College St, Suite 100, Beaumont, TX 77701-4691 | 2012-01-03 |
| 1346417342 | Beaumont Neurosurgical Spine Associates Pa | Neurological Surgery | 6025 Metropolitan Dr, Suite 205, Beaumont, TX 77706-2408 | 2008-05-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447869003 | Scott B Phillips Pllc | Neurological Surgery | 1303 Mccullough Ave Ste 166, San Antonio, TX 78212-5603 | 2020-07-29 |
| 1710595996 | Laredo Surgical Center | Neurological Surgery | 10410 Medical Loop Bldg 4a, Laredo, TX 78045-6672 | 2020-07-14 |
| 1710506803 | Houston Texas Neurosurgical Institute. Pllc | Neurological Surgery | 925 Gessner Rd Ste 500, Houston, TX 77024-2644 | 2020-04-09 |
| 1760046080 | Adam Franklin Carlton | Neurological Surgery | 301 University Blvd # Mr 0517, Galveston, TX 77555-0517 | 2019-04-23 |
| 1235698911 | South Texas Neurosurgery Associates | Neurological Surgery | 3475 W Alton Gloor Blvd Ste A, Brownsville, TX 78520 | 2019-03-13 |
| 1376009951 | Dallas Center for Neuro and Spine Excellence LLP | Neurological Surgery | 4013 Centenary Ave, Dallas, TX 75225-5430 | 2019-02-19 |
| 1679040414 | Advances Istitute for Joint and Spine Disorders | Neurological Surgery | 6160 Windhaven Pkwy Ste 200, Plano, TX 75093-2138 | 2018-10-30 |
| 1891270989 | Alma Diana Garza | Neurological Surgery | 1139 E Sonterra Blvd Ste 301, San Antonio, TX 78258-4348 | 2018-09-25 |
| 1861975922 | Neurosurgical Group of Texas, LLP | Neurological Surgery | 8731 Katy Fwy Ste 325, Houston, TX 77024-1703 | 2018-09-13 |
| 1508347998 | William T Mccullough Md Pa | Neurological Surgery | 1101 Raintree Cir Ste 12o, Allen, TX 75013-4922 | 2018-08-24 |
| Find all providers with the same taxonomy | ||||
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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.