MEDICARE: PHYLLIS J CLARK PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	1094233	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	659542	OTHER	TX	BCBS PROVIDER NUMBER

General Provider Information

NPI Number	:	1881705622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PHYLLIS J CLARK PT

Provider Business Mailing Address
First Line	:	2712 CHAMBERLAIN CIR
Second Line	:
City	:	PLANO
State	:	TX
Zip	:	75023-5401
Country	:	US
Telephone Number	:	972-596-0886
Fax Number	:

Provider Business Practice Location Address
First Line	:	2801 REGAL RD
Second Line	:	SUITE 109
City	:	PLANO
State	:	TX
Zip	:	75075-6315
Country	:	US
Telephone Number	:	972-985-2311
Fax Number	:	972-985-8711

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1538160593 — ROXANNE MONGEON PA
Practice Location Address:

2801 REGAL RD , SUITE 108
PLANO, TX
75075-6315

Practice Phone: 972-599-0080
Practice Fax: 972-599-0082

1568484400 — JANET WOLDMAN FRICK PH.D.
Practice Location Address:

2801 REGAL RD , #108
PLANO, TX
75075-6315

Practice Phone: 972-612-1121
Practice Fax: 214-474-0466

1942213434 — MRS. MARGARET ANN RAIDT L.P.C., L.M.F.T.
Practice Location Address:

2801 REGAL RD STE 108
PLANO, TX
75075-6315

Practice Phone: 972-424-1437
Practice Fax:

1093927501 — MS. PAULETTE R ROLLINS LPC, NCC
Practice Location Address:

2801 REGAL RD
PLANO, TX
75075-6315

Practice Phone: 214-868-0016
Practice Fax: 425-962-0016

1285824656 — DR. JACQUELINE HOOD PH.D.
Practice Location Address:

2801 REGAL RD , SUITE 106
PLANO, TX
75075-6315

Practice Phone: 972-827-7921
Practice Fax:

1205012788 — ROLLINS COUNSELING LLC
Practice Location Address:

2801 REGAL RD , SUITE 105
PLANO, TX
75075-6315

Practice Phone: 214-868-0016
Practice Fax:

Directions to “ PHYLLIS J CLARK PT” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.