Daniel Lewis Clark, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

2152204 Issued in TX

Practice address

1919 Brinker Rd
Denton, TX 76208-6215

Phone

(940) 380-9494

NPI assigned

Feb 3, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1580688000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580688000000",
    "number": "1326679846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 MAGNOLIA ST",
            "city": "GAINESVILLE",
            "state": "TX",
            "postal_code": "762402933",
            "telephone_number": "903-203-4089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 BRINKER RD",
            "city": "DENTON",
            "state": "TX",
            "postal_code": "762086215",
            "telephone_number": "940-380-9494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "DANIEL",
        "middle_name": "LEWIS",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-02-03",
        "last_updated": "2020-02-03",
        "certification_date": "2020-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TX",
            "license": "2152204",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Civitas Clinical Services LLC
• Erin Clancy
• Clara H. Henry, M.D., P.a.
• Brian Clark, PHARMD
• Crystal Clark, PHD
• Eva-Sophia Clark, MA, LCSW, LCDC, EMDR
• Kayla Ennette Clark, MS, LPC
• Natalie Lauren Clark
• Susan Zeringue Clark, OT
• Anne Kathleen Clarke, LPC

• Physical Therapy Assistant in Denton, TX
• Providers in Denton, TX by specialty
• Physical Therapy Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2020; 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.