BRANDY B CLARK (NPI# 1811505688) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811505688 |
| Entity Type | Individual |
| Full Name | BRANDY B CLARK |
| Practice Address |
11927 Sonora Springs Dr Tomball TX 77375-1760 |
| Mailing Address |
Po Box 682781 Houston TX 77268-2781 |
| Practice Telephone | 8322989095 |
| Practice Fax Number | 2813106576 |
| Enumeration Date | 2020-07-17 |
| Last Update Date | 2020-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 372600000X | Adult Companion | Nursing Service Related Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 385H00000X | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902405095 | Brandy Clark | Nurse Practitioner | 2511 Old Cornwallis Rd Ste 200, Durham, NC 27713-1869 | 2020-10-20 |
| 1669019600 | Brandy Lee Clark | Nurse Practitioner | 1575 Chattanooga Ave Ste 1, Dalton, GA 30720-2672 | 2019-12-10 |
| Street Address |
11927 SONORA SPRINGS DR |
| City | TOMBALL |
| State | TX |
| Zip Code | 77375-1760 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265063986 | Assured Primary Care Group, Inc. | Respite Care | 11927 Sonora Springs Dr, Tomball, TX 77375-1760 | 2020-01-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063997997 | Michael Jahn | Counselor | 103 Tadpole Court, Woodlands, TX 77375 | 2018-09-26 |
| 1467943266 | Willow Creek Smiles Pllc | Clinic/Center | 9166 Farm To Market 2920 Rd, Suite 900, Tomball, TX 77375 | 2018-05-29 |
| 1962991315 | Betty Harbour | Technician | 10 Capri Bend, Tom Ball, TX 77375 | 2018-05-01 |
| 1336652353 | Juanita Dolores Paras | Occupational Therapy Assistant | 19203 Carriage Vale Ln, Tomball, TX 77375 | 2017-11-13 |
| 1215446885 | Ideal Dental of Augusta Pines Pllc | Dentist | 25760 Kuykendahl, Suite A, Tomball, TX 77375 | 2017-09-26 |
| 1285151936 | Cagney Reeves | Pharmacist | 28520 Tobmall Parkway, Tomball, TX 77375 | 2017-08-24 |
| 1710411616 | Perseverance Heatlh Innovation Ltd | Contractor | 21706 Willow Downs, Tomball, TX 77375 | 2017-04-18 |
| 1972042158 | Rite Choice Healthcare, Pllc | Dentist | 27030 Tomball Pkwy, Tomball, TX 77375 | 2017-02-21 |
| 1306398029 | Pharmcare Usa of Houston LLC | Pharmacy | 420 Chestnut Business Park Dr., Suite C, Tomball, TX 77375 | 2016-10-28 |
| 1992256325 | Wal-mart Stores Texas, LLC | Technician/Technologist | 25800 Kuykendahl Road, Tomball, TX 77375 | 2016-10-20 |
| Find all providers in zip 77375 | ||||
| Taxonomy Code | 372600000X |
| Grouping | Nursing Service Related Providers |
| Classification | Adult Companion |
| An individual who provides supervision, socialization, and non-medical care to a functionally impaired adult. Companions may assist or supervise the individual with such tasks as meal preparation, laundry and shopping, but do not perform these activities as discrete services. These services are provided in accordance with a therapeutic goal in the plan of care. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607480 | Lisseth Carolina Bautista | Adult Companion | 25218 Spring Iris Ln, Katy, TX 77494-5580 | 2020-10-25 |
| 1417556689 | Angel's Place | Adult Companion | 909 Highland Dr, Kilgore, TX 75662-4040 | 2020-10-20 |
| 1134733397 | Edna Renee Phillips | Adult Companion | 3352 Jan Ct, Katy, TX 77493-1379 | 2020-09-04 |
| 1396355483 | J Person Inc Dba Living Word Home Care Service | Adult Companion | 1202 Evans Rd Apt 1225, San Antonio, TX 78258-6969 | 2020-08-04 |
| 1841808771 | Kidz Plus Medical Clinic | Adult Companion | 8613 Martin Luther King Blvd, Houston, TX 77033-2307 | 2020-07-16 |
| 1679199806 | Tammy Swan | Adult Companion | 4606 Fm 1960 Rd W Ste 640, Houston, TX 77069-4600 | 2020-06-23 |
| 1942826318 | Lacinder Roseann King | Adult Companion | 1205 Switchgrass Ln, Crowley, TX 76036-4341 | 2020-06-22 |
| 1841815768 | Bridget Danielle Hill | Adult Companion | 2417 Castle Creek Dr, Little Elm, TX 75068-4887 | 2020-06-16 |
| 1811512528 | Marina Martin Del Campo | Adult Companion | 11030 Oasis Dr, El Paso, TX 79936-1023 | 2020-06-09 |
| 1710513239 | Suzanne F Moore | Adult Companion | 5801 Rayburn Dr, Fort Worth, TX 76133-3026 | 2020-03-16 |
| 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.