James T. Clark, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

D3181 Issued in TX

Practice address

1100 E Lake St
Suite 330
Tyler, TX 75701-3343

Phone

(903) 595-5522

Fax

(903) 595-3834

NPI assigned

Jan 18, 2007

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073665964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 E LAKE ST",
            "address_2": "SUITE 330",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013343",
            "telephone_number": "903-595-5522",
            "fax_number": "903-595-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 E LAKE ST",
            "address_2": "SUITE 330",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757013343",
            "telephone_number": "903-595-5522",
            "fax_number": "903-595-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "JAMES",
        "middle_name": "T.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "D3181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID #",
            "identifier": "751477994",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11235461",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "041539337",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Clakley
• Cade Wesley Clark, MD
• Carey Alexander Clark III, MD
• Cheryl K Clark
• Gregory Scott Clark Jr.
• Jennifer Clark
• Kendrick Clark
• Lauren Clark, MS, RD, LD, CNSC
• Miranda Clark
• Mitchell Lee Clark, MD

• Specialist in Tyler, TX
• Providers in Tyler, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.