Organization Active NPI

Gloria Clark, MD PA

  • Obstetrics & Gynecology Physician
  • El Paso, TX
National Provider Identifier
1407014855
Registry record updated Jun 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
J8961 Issued in TX
Legal business name
GLORIA CLARK, MD PA
Practice address
10201 Gateway Blvd W
Suite 400
El Paso, TX 79925-7652
Phone
(915) 598-7900
Fax
(915) 598-7902
NPI assigned
Jun 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2008

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

Authorized official

Name
Dr. Glorai Clark, M.D.
Title
Owner
Phone
(915) 598-7900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207V00000X J8961 TX Primary

Addresses

Primary practice location

10201 Gateway Blvd W
Suite 400
El Paso, TX 79925-7652

Mailing address

10201 Gateway Blvd W
Suite 400
El Paso, TX 79925-7652
Phone (915) 598-7900

Other identifiers 1

IdentifierTypeStateIssuer
096531102MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1212278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212278400000",
    "number": "1407014855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10201 GATEWAY BLVD W",
            "address_2": "SUITE 400",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799257652",
            "telephone_number": "915-598-7900",
            "fax_number": "915-598-7902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10201 GATEWAY BLVD W",
            "address_2": "SUITE 400",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799257652",
            "telephone_number": "915-598-7900",
            "fax_number": "915-598-7902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLORIA CLARK, MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-01",
        "last_updated": "2008-06-01",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "GLORAI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "915-598-7900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "J8961",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096531102",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2008; 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.