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General NPI Number Information
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NPI Number | 1174902621
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Entity Type | Organization
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Legal Business Name | STEVEN CLARK MD PLLC
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Dates
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Enumeration Date | 05/29/2015
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Last Update Date | 07/24/2025
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Provider Practice Location Address
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Address Line | 18170 DALLAS PKWY STE 202
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City | DALLAS
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State | TX
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Zip | 75287-7149
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Country | US
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Telephone | 469-675-3659
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Fax | 469-675-3181
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Provider Business Mailing Address
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Address Line | 4510 MEDICAL CENTER DRIVE SUITE 305
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City | MCKINNEY
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State | TX
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Zip | 75069-1604
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Country | US
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Telephone | 469-675-3659
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Fax | 469-675-3181
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL/OWNER
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Name | DR. STEVEN A CLARK
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Credential | M.D.
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Telephone | 469-675-3659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | N3567
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | N3567
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2086S0105X
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Taxonomy Name | Surgery of the Hand (Surgery) Physician
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License Number | N3567
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | N3567
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License Number State | TX
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