Individual provider Active NPI

Matthew Timothy Clark, M.D.

  • Gastroenterology Physician
  • Shenandoah, TX
National Provider Identifier
1497072227
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
R2309 Issued in TX
Practice address
129 Vision Park Blvd Ste 307
Shenandoah, TX 77384-3024
Phone
(936) 321-5440
Fax
(369) 271-3705
NPI assigned
May 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X R2309 TX Primary

Addresses

Primary practice location

129 Vision Park Blvd Ste 307
Shenandoah, TX 77384-3024

Mailing address

129 Vision Park Blvd Ste 307
Shenandoah, TX 77384-3024
Phone (936) 321-5440

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170517001820 TX Practitioner - Gastroenterology 1850532581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Gastroenterology Partners of North Houston PLLCGroup PAC ID 0143563304, 10 clinicians

Practice addresses (Care Compare)

129 Vision Park Blvd
Suite 307
Shenandoah, TX 77384-3024
Phone 9363215440135

Hospital & facility affiliations

  • St Luke'S the Woodlands Hospital Hospital, The Woodlands, TX, CCN 450862
  • Houston Methodist the Woodlands Hospital Hospital, The Woodlands, TX, CCN 670122
  • Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy222
Upper gastrointestinal (GI) endoscopy for acid reflux299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
R2309TXMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier General and Colorectal Surgery, PA CurrentSince Jun 21, 2022 Accepting new patients
Gastroenterology Partners of North Houston PLLC Gastroenterology CurrentSince Dec 1, 2020 Accepting new patients
Carolina Digestive Health Associates, PA PastSince Oct 29, 2023 Accepting new patients

Locations

837 FM 1960 Rd W
Ste 105
Houston, TX 77090
Phone (281) 453-7158

119 Medical Park Ln
Ste C
Huntsville, TX 77340
Phone (936) 271-3400

129 Vision Park Blvd
Ste 212
Shenandoah, TX 77384
Phone (713) 955-2889

129 Vision Park Blvd
Ste 307
Shenandoah, TX 77384
Phone (936) 321-5440

17201 Interstate 45 S
The Woodlands, TX 77385
Phone (936) 270-2000

Organizations & group practices 3

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1272931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1497072227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 VISION PARK BLVD STE 307",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843024",
            "telephone_number": "936-321-5440",
            "fax_number": "866-538-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 VISION PARK BLVD STE 307",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843024",
            "telephone_number": "936-321-5440",
            "fax_number": "369-271-3705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "MATTHEW",
        "middle_name": "TIMOTHY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-04",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "TX",
            "license": "R2309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shenandoah, TX

Sources for this page

Verify at the official NPI Registry.