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DR. JEREMY DEAN CLARK DO NPI 1902122443


NPI Information

NPI: 1902122443
Provider Name: DR. JEREMY DEAN CLARK, DO
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

Organization: TEXAS RADIOLOGY ASSOCIATES LLP

PECOS Registration: Yes

Address:
3901 W 15TH ST
PLANO, TX
ZIP 75075
Phone: (972) 596-6800
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DR. Jeremy Dean Clark, DO is a diagnostic radiology radiology in Plano, TX with 14 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. DR. Jeremy Dean Clark, DO NPI is 1902122443. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: KANSAS CITY UNIVERSITY OF MED & BIOSCIENCES, COLLEGE OF OSTEO MED
Graduation Year:2010

The provider's business location address is:

3901 W 15TH ST
PLANO, TX
ZIP 75075-738
Phone: (972) 596-6800

The NPI 1902122443 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/8/2010 and was last updated on 5/10/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
22085R0202XRadiologyDiagnostic RadiologyQ7164TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.