NPIMap

Individual provider Active NPI

Gary R Clark, D.O.

  • Emergency Medicine Physician
  • Dallas, TX
National Provider Identifier
1174563803
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
L8651 Issued in TX
Practice address
2929 S Hampton Rd
Dallas, TX 75224-3026
Phone
(214) 623-4400
NPI assigned
Jun 8, 2006
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X L8651 TX Primary

Addresses

Primary practice location

2929 S Hampton Rd
Dallas, TX 75224-3026

Mailing address

1529 Hackett Creek Dr
McKinney, TX 75070-5068
Phone (972) 886-5702

Other identifiers 1

IdentifierTypeStateIssuer
T0134490OtherTXCONTROLLED SUBSTANCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Humble Emergency Physicains Professional Association Emergency Medicine Past Accepting new patients
Republic Emergency Services PA Emergency Medicine Past Accepting new patients
Greater San Antonio Emergency Physicians, PA Emergency Medicine Past Accepting new patients
Shawnee Trail Emergency Physicians Emergency Medicine Past Accepting new patients
Rajeev Sareen, MD Past Accepting new patients
Kiest Loop Trail Emergency Physicians PLLC Emergency Medicine Past Accepting new patients
E Care Emergency Frisco LLC Past Accepting new patients
E Care Emergency McKinney, L.P. Past Accepting new patients
Cowboy Capital Emergency Physicians Emergency Medicine Past Accepting new patients
Texas Em-1 Medical Services, PA Emergency Medicine Past Accepting new patients
Harlingen Emergency Medical Associates, PA Emergency Medicine Past Accepting new patients
Southwest Medical Associates, Inc. Emergency Medicine Past Accepting new patients

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1174563803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1529 HACKETT CREEK DR",
            "city": "MCKINNEY",
            "state": "TX",
            "postal_code": "750705068",
            "telephone_number": "972-886-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2929 S HAMPTON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752243026",
            "telephone_number": "214-623-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GARY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "L8651",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE",
            "identifier": "T0134490",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.