Active NPI
Clatyon Green
- Audiologist
- Victoria, TX
National Provider Identifier
1366654402
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Audiologist
- License
- 51387
- Practice address
- 4203 North Main St.
Victoria, TX 77901 - Phone
- (361) 573-2500
- Fax
- (361) 573-2506
- NPI assigned
- May 3, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Audiologist | 231H00000X | 51387 | TX | Primary |
Addresses
Primary practice location
4203 North Main St.
Victoria, TX 77901
Mailing address
4203 North Main St.
Victoria, TX 77901
Phone (361) 573-2500
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
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51387 | TX | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274659200000",
"number": "1366654402",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4203 NORTH MAIN ST.",
"city": "VICTORIA",
"state": "TX",
"postal_code": "77901",
"telephone_number": "361-573-2500",
"fax_number": "361-573-2506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4203 NORTH MAIN ST.",
"city": "VICTORIA",
"state": "TX",
"postal_code": "77901",
"telephone_number": "361-573-2500",
"fax_number": "361-573-2506"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREEN",
"first_name": "CLATYON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2010-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "231H00000X",
"taxonomy_group": "",
"desc": "Audiologist",
"state": "TX",
"license": "51387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Victoria, TX
- Gramercy Emergency Center Victoria LLC (Mercer Emergency Center)
- Veronica Goirena Granados, FNP
- Jack D Gray, FNP
- Greater Texas Spine & Neurosurgery PA
- Cheryl Ann Green, MSW, LCSW
- Stacey Michelle Greer, LPC-A
- Jack Greeson, PHD
- Julane Gregory, NP-C
- Carolina Espinoza Griffin, FNP
- Grovers Emergency Medicine Associates, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.