| Jared Dale Clark, APN | |
|
114 W Us Highway 82, New Boston, TX 75570-2804 | |
| (479) 530-3245 | |
| (479) 530-3245 |
| Full Name | Jared Dale Clark |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Experience | 7 Years |
| Location | 114 W Us Highway 82, New Boston, Texas |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467011239 | NPI | - | NPPES |
| AP141588 | Other | TX | APN LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LG0600X | Nurse Practitioner - Gerontology | 215134 (Arkansas) | Primary |
| 363LG0600X | Nurse Practitioner - Gerontology | AP141588 (Texas) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Christus Homecare - St Michael | Texarkana, TX | Home health agency |
| Christus St Michael Health System | Texarkana, TX | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| East Texas Border Health Clinic | 8820038565 | 50 |
| East Texas Border Health Clinic | 8820038565 | 50 |
| Entity Name | East Texas Border Health Clinic |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558329797 PECOS PAC ID: 8820038565 Enrollment ID: O20050511001030 |
| Mailing Address | Practice Location Address |
|---|---|
| Jared Dale Clark, APN Po Box 1326, Marshall, TX 75671-1326 Ph: (903) 927-3782 | Jared Dale Clark, APN 114 W Us Highway 82, New Boston, TX 75570-2804 Ph: (479) 530-3245 |
Mrs. Letha H Colquitt, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 910 James Bowie Dr, New Boston, TX 75570 Phone: 903-614-5950 | |
Paul A Smith, ANP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 128 N Ellis St, New Boston, TX 75570 Phone: 903-628-1104 Fax: 903-628-0104 | |
Mary Dutchover, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 910 James Bowie Dr, New Boston, TX 75570 Phone: 903-614-5950 Fax: 903-614-5950 | |
Dr. Deborah S Flournoy, PHD, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 304 W Us Highway 82, New Boston, TX 75570 Phone: 903-628-0041 Fax: 903-628-0043 | |
Mary P Stanley, ANP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 910 James Bowie Dr, New Boston, TX 75570 Phone: 903-614-5950 Fax: 903-614-5955 | |
Dr. Trey W Pirkey, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 310 E Hoskins St, New Boston, TX 75570 Phone: 903-628-7877 Fax: 903-628-7876 |