NPIMap

Organization Active NPI

Clark Colville and Kelly Heetland Specialty Partners of Texas PLLC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Seguin, TX
National Provider Identifier
1386522233
Registry record updated Jan 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
CLARK COLVILLE AND KELLY HEETLAND SPECIALTY PARTNERS OF TEXAS PLLC
Practice address
205 S State Highway 46
Seguin, TX 78155-7504
Phone
(830) 372-9811
NPI assigned
Aug 26, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2026

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

Authorized official

Name
Krystal Richardson
Title
Director of RCM
Phone
(214) 934-7995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

205 S State Highway 46
Seguin, TX 78155-7504

Mailing address

820 W 42ND St Ste 2300
Scottsbluff, NE 69361-5016
Phone (308) 260-0241

Other practice location 1

1890 Medical Pkwy Ste 101
San Marcos, TX 78666-8496
Phone (512) 782-2046

Other names 2

  • Orthodontic Specialists of San Marcos Doing business as
  • Orthodontic Specialists of Seguin Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clark Colville and Kelly Heetland Specialty Partners of Texas PLLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1890 Medical Pkwy
Ste 101
San Marcos, TX 78666
Phone (512) 782-2046

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1756166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767830400000",
    "number": "1386522233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 W 42ND ST STE 2300",
            "city": "SCOTTSBLUFF",
            "state": "NE",
            "postal_code": "693615016",
            "telephone_number": "308-260-0241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 S STATE HIGHWAY 46",
            "city": "SEGUIN",
            "state": "TX",
            "postal_code": "781557504",
            "telephone_number": "830-372-9811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1890 Medical Pkwy Ste 101",
            "address_purpose": "LOCATION",
            "city": "San Marcos",
            "state": "TX",
            "postal_code": "786668496",
            "country_code": "US",
            "telephone_number": "512-782-2046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CLARK COLVILLE AND KELLY HEETLAND SPECIALTY PARTNERS OF TEXAS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-08-26",
        "last_updated": "2026-01-08",
        "certification_date": "2026-01-08",
        "status": "A",
        "authorized_official_last_name": "RICHARDSON",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "DIRECTOR OF RCM",
        "authorized_official_telephone_number": "214-934-7995"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Orthodontic Specialists of San Marcos",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Orthodontic Specialists of Seguin",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seguin, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2026; 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.