Gail Suzan Clark, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA02727 Issued in TX

Practice address

4314 Yoakum Blvd
Houston, TX 77006-5818

Phone

(713) 850-0049

Fax

(713) 850-0036

NPI assigned

Nov 2, 2007

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Senior Psychcare of San Antonio I, PLLC

  • Psychiatry Physician
  • Houston, TX
  • NPI 1225324270
  Medicare reassignment

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1386823615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4314 YOAKUM BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770065818",
            "telephone_number": "713-850-0049",
            "fax_number": "713-850-0036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4314 YOAKUM BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770065818",
            "telephone_number": "713-850-0049",
            "fax_number": "713-850-0036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "GAIL",
        "middle_name": "SUZAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-02",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dancey Clark, LPC
• Deonna Michelle Clark, NP
• Devonte Clark
• Ellen Estelle Clark, LCDC
• Eva Helen Clark, M.D., PHD
• Gary David Clark, MD
• Gina Clark, LMT
• Helen Daifotis Clark, MD
• Jamarri Clark
• Jennie Clark, APRN

• Physician Assistant in Houston, TX
• Providers in Houston, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.