William D Clark, MD

Primary specialty

Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X

License

D6986 Issued in TX

Practice address

333 N Santa Rosa Street
Goldsbury Center Lower Level
San Antonio, TX 78207-3108

Phone

(210) 704-2335

Fax

(210) 704-2335

NPI assigned

Mar 30, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: william.clark.1@8363.direct.athenahealth.com

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.

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• Dell Children'S Medical Group

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• Seton Family of Doctors

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  NPD (past)
• Osler Medical Inc

  • Multi-Specialty Clinic/Center
  • Melbourne, FL
  • NPI 1356308670
  NPD (past)

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

{
    "created_epoch": "1143676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317772800000",
    "number": "1306807268",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA STREET",
            "address_2": "GOLDSBURY CENTER LOWER LEVEL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108",
            "telephone_number": "210-704-2335",
            "fax_number": "210-704-4723"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 N SANTA ROSA STREET",
            "address_2": "GOLDSBURY CENTER LOWER LEVEL",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782073108",
            "telephone_number": "210-704-2335",
            "fax_number": "210-704-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "WILLIAM",
        "middle_name": "D",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-30",
        "last_updated": "2011-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "TX",
            "license": "D6986",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115705908",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stephanie Clark
• Summer Michele Clark, ACNP
• Tammy Lynn Clark, M.A., LPC
• Taylor Clark, LPC
• Tracy S Clark, PA
• Amber Lee Clarke, LPC-ASSOCIATE
• Angela Nicole Clarke
• Caroline Clarke
• Chantel R Clarke
• Darrell Clarke, LPC

• Pediatric Otolaryngology Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Pediatric Otolaryngology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.