Organization Active NPI

Allen Clark IV

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Houston, TX
National Provider Identifier
1780505529
Registry record updated Jul 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityTaxonomy code 320900000X
Legal business name
ALLEN CLARK IV
Practice address
15947 Walnut Wood Dr
Houston, TX 77084-2911
Phone
(702) 515-9048
Fax
(702) 515-9048
NPI assigned
Jul 24, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2026

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

Authorized official

Name
Allen Clark IVNPI 1558192252
Title
Program Manager/Owner
Phone
(702) 515-9048

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Developmentally Disabled Services Day Training Agency 251C00000X
Community/Behavioral Health Agency 251S00000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Primary

Addresses

Primary practice location

15947 Walnut Wood Dr
Houston, TX 77084-2911

Mailing address

15947 Walnut Wood Dr
Houston, TX 77084-2911
Phone (702) 515-9048

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1784851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784851200000",
    "number": "1780505529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15947 WALNUT WOOD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770842911",
            "telephone_number": "702-515-9048",
            "fax_number": "702-515-9048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15947 WALNUT WOOD DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770842911",
            "telephone_number": "702-515-9048",
            "fax_number": "702-515-9048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLEN CLARK IV",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-24",
        "last_updated": "2026-07-24",
        "certification_date": "2026-07-24",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "ALLEN",
        "authorized_official_title_or_position": "PROGRAM MANAGER/OWNER",
        "authorized_official_telephone_number": "702-515-9048",
        "authorized_official_name_suffix": "IV"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "320900000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2026; 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.