Elizabeth Maurine Clark, APRN, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

743837 Issued in TX

Practice address

6301 Gaston Ave Ste 100W
Dallas, TX 75214

Phone

(214) 827-3610

Fax

(214) 821-4017

NPI assigned

Oct 31, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Elizabeth Maurine Iskander Former name

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

Practice roles

Interoperability endpoints

• Direct secure messaging: elizabeth.fortner.p2@direct.alegiscare.nextgenshare.com
• Direct secure messaging: eclark460518@direct.sw.org
• FHIR API: https://fhir4.healow.com/fhir/r4/BBAABA

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.

• Texas Neurology, P.a.

  • Community/Retail Pharmacy
  • Dallas, TX
  • NPI 1801377528
  NPD (past)

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

{
    "created_epoch": "1351641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561334400000",
    "number": "1548514367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6301 GASTON AVE STE 100W",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752146273",
            "telephone_number": "214-827-3610",
            "fax_number": "214-821-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6301 GASTON AVE STE 100W",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75214",
            "telephone_number": "214-827-3610",
            "fax_number": "214-821-4017"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 Troup Hwy",
            "address_2": "Tyler",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757032356",
            "country_code": "US",
            "telephone_number": "903-526-7055",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2821 George Bush Hwy Ste 303",
            "address_purpose": "LOCATION",
            "city": "Richardson",
            "state": "TX",
            "postal_code": "750824280",
            "country_code": "US",
            "telephone_number": "214-540-1400",
            "fax_number": "214-821-4017",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLARK",
        "first_name": "ELIZABETH",
        "middle_name": "MAURINE",
        "name_prefix": "Ms.",
        "credential": "APRN, FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-31",
        "last_updated": "2019-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "743837",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "ISKANDER",
            "middle_name": "MAURINE",
            "prefix": "MS.",
            "credential": "APRN, FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Chelsey Marie Clark
• Cheyla Romaine Clark, MPH, MS, CGC
• Deborah Jean Clark, LMSW,LMFT
• Edward Williams Clark, M.D.
• Elise N. Clark, FNP
• Ethan Clark, MA, LPC
• Gary R Clark, D.O.
• Glenn D Clark, DDS
• Gordon Michael Clark Sr., M.D.
• Haley Routh Clark, MD

• Family Nurse Practitioner in Dallas, TX
• Providers in Dallas, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2019; 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.