Tracey Clark

Primary specialty

SpecialistTaxonomy code 174400000X

License

225700000X Issued in TX

Practice address

2201 Main St
#1200
Dallas, TX 75201-4327

Phone

(972) 900-2708

NPI assigned

Mar 7, 2016

Last updated

Mar 7, 2016By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457308800000",
    "number": "1720449556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 MAIN ST",
            "address_2": "1200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752014327",
            "telephone_number": "972-900-2708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 MAIN ST",
            "address_2": "#1200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752014327",
            "telephone_number": "972-900-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLARK",
        "first_name": "TRACEY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-03-07",
        "last_updated": "2016-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "225700000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSAGE THERAPY",
            "identifier": "225700000X",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven Michael Clark, MD
• Sue Clark, LPC
• Tampa Catherine Clark, DNP, APRN, CNS
• Tejauna Clark, OT
• Thomas Christopher Clark
• Tracy M Clark, CPHT
• Veurmer Clark, O.D.
• William Randolph Clark, LPC
• Clarke D. Newman, OD, PC (Plaza Vision Center)
• Christopher A Clarke, MD

• Specialist in Dallas, TX
• Providers in Dallas, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; 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.