Camille Clark, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

G4917 Issued in TX

Practice address

7777 Forest LN
#D550
Dallas, TX 75230

Phone

(972) 566-7009

Fax

(972) 566-6289

NPI assigned

Oct 25, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

University of Texas Medical School at San Antonio, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Obstetrics and Gynecology PAGroup PAC ID 4789653684, 3 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Medical City Dallas Hospital Hospital, Dallas, TX, CCN 450647
• Medical City Plano Hospital, Plano, TX, CCN 450651

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: cclark1487409@direct.sw.org

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

• Obstetrics & Gynecology PA

  • Specialist
  • Dallas, TX
  • NPI 1649222647
  Medicare reassignment Care Compare group
• Columbia Hospital at Medical City Dallas Subsidiary LP

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1689628984
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Columbia Hospital at Medical City Dallas Subsidiary LP

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1023180502
  Care Compare affiliation
• Columbia Hospital at Medical City Dallas Subsidiary LP

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1689628984
  Care Compare affiliation
• Columbia Medical Center of Plano Subsidiary LP

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1699726406
  Care Compare affiliation

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295819316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "address_2": "#D550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75230",
            "telephone_number": "972-566-7009",
            "fax_number": "972-566-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN",
            "address_2": "#D550",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75230",
            "telephone_number": "972-566-7009",
            "fax_number": "972-566-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "CAMILLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "G4917",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audra Tess Clark, MD
• Ben Clark, DC
• Ben Clark Jr., DPM
• Braden Michael Clark, CRNA
• Brian Clark
• Chelsey Marie Clark
• Cheyla Romaine Clark, MPH, MS, CGC
• Deborah Jean Clark, LMSW,LMFT
• Edward Williams Clark, M.D.
• Elise N. Clark, FNP

• Obstetrics & Gynecology Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Obstetrics & Gynecology Physician 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.