MR. CHARLES WARREN CLARK JR. (NPI# 1811290935) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811290935 |
| Entity Type | Individual |
| Full Name | MR. CHARLES WARREN CLARK JR. |
| Credential | LMT |
| Practice Address |
19577 Fm 2854 Rd Montgomery TX 77316-3150 |
| Practice Telephone | 9365370948 |
| Mailing Telephone | 9365370948 |
| Enumeration Date | 2010-12-11 |
| Last Update Date | 2010-12-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225700000X | Massage Therapist | MT038025 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| 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 |
| 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 |
19577 FM 2854 RD |
| City | MONTGOMERY |
| State | TX |
| Zip Code | 77316-3150 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053940494 | Alliance Mri Woodforest LLC | Clinic/Center | 750 Fish Creek Thoroughfare, Suite 180, Montgomery, TX 77316 | 2020-04-07 |
| 1457997058 | Kristynik Eye Care Pllc | Optometrist | 791 Fish Creek Thoroughfare, Suite 50, Montgomery, TX 77316 | 2019-11-19 |
| 1710532684 | Knee Scooters Houston LLC | Durable Medical Equipment & Medical Supplies | 9937 Chestnut Ct, Montgomery, TX 77316 | 2019-08-07 |
| 1134772270 | Sandstone Medical | Clinic/Center | 795 Fish Creek Thoroughfare Ste 270, Montgomery, TX 77316 | 2019-07-18 |
| 1356801195 | Woodforest Fine Dentistry | Clinic/Center | 791 Fish Creek Thoroughfare Ste 40, Montgomery, TX 77316 | 2019-03-20 |
| 1467923169 | Jody Michele Reed | Counselor | 6360 Honea Egypt Rd, Montgomery, TX 77316 | 2018-12-06 |
| 1811490949 | Gregory Crocker | Chiropractor | 125 Blue Herron Dr Suite B, Montgomery, TX 77316 | 2018-03-15 |
| 1114302122 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 2180 Woodforest Parkway N, Montgomery, TX 77316 | 2015-07-21 |
| 1518376698 | Jennifer Miller Hobock | Dentist | 2300 Woodforest Pkwy N, Ste 700, Montgomery, TX 77316 | 2014-08-04 |
| 1861815342 | Reese Ochoa | Chiropractor | 125 Blue Heron Dr Ste B, Montgomery, TX 77316 | 2014-02-04 |
| Find all providers in zip 77316 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417564527 | Huldah Deberry | Massage Therapist | 8449 Crossland Loop Ste 108, Montgomery, AL 36117-0917 | 2020-09-23 |
| 1225649791 | Oasis Massage and Bodywork, Inc. | Massage Therapist | 5287 Vaughn Rd, Montgomery, AL 36116-1104 | 2020-08-10 |
| 1174141428 | Nicholas Pernell Vines Sr. | Massage Therapist | 2201 Sagewood Dr, Montgomery, AL 36117-2428 | 2020-07-13 |
| 1245854017 | Danney Lester Hendrix | Massage Therapist | 5485 Atlanta Hwy, Root Salon Building, Montgomery, AL 36109 | 2020-06-08 |
| 1881139731 | Nikki Roberts | Massage Therapist | 7111 Halcyon Park Dr Ste B, Montgomery, AL 36117-7714 | 2017-01-02 |
| 1558698050 | Laura Lee Svatek | Massage Therapist | 211 Cool Cove, Montgomery, TX 77356 | 2009-11-04 |
| 1649507179 | Sheila Jean Mistric | Massage Therapist | 24563 Clark Rd, Montgomery, TX 77316-3876 | 2009-11-04 |
| 1023345501 | Desaray Leigh Rich | Massage Therapist | 15260 Highway 105 W # 125, Montgomery, TX 77356-5259 | 2009-11-04 |
| 1962655332 | Kathy J Stricker | Massage Therapist | 518 Paradise Ln, Montgomery, TX 77356-5725 | 2008-10-29 |
| 1245830637 | Rebecca Jean Allen | Massage Therapist | 6200 Pfeiffer Rd, Montgomery, OH 45242-5862 | 2020-10-27 |
| Find all providers in MONTGOMERY | ||||
| City | MONTGOMERY |
| Zip Code | 77316 |
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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.