Active NPI
Gerardo Clark, OPTICIAN
- Optometrist
- Corpus Christi, TX
National Provider Identifier
1891056032
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3101
- Practice address
- 4124 Ayers St
Corpus Christi, TX 78415-5315 - Phone
- (361) 854-0115
- Fax
- (361) 854-0116
- NPI assigned
- Jun 5, 2012
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3101 | TX | Primary |
Addresses
Primary practice location
4124 Ayers St
Corpus Christi, TX 78415-5315
Mailing address
4124 Ayers St
Corpus Christi, TX 78415-5315
Phone (361) 854-0115
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338854400000",
"number": "1891056032",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4124 AYERS ST",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784155315",
"telephone_number": "361-854-0115",
"fax_number": "361-854-0116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4124 AYERS ST",
"city": "CORPUS CHRISTI",
"state": "TX",
"postal_code": "784155315",
"telephone_number": "361-854-0115",
"fax_number": "361-854-0116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLARK",
"first_name": "GERARDO",
"name_prefix": "Mr.",
"credential": "OPTICIAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-06-05",
"last_updated": "2012-06-05",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "3101",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corpus Christi, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.