Dr. Stacey Leigh Clark
Pediatric Otolaryngology
3705 Medical Pkwy Suite 200
Austin
, Texas 78705-1019
Dr. Stacey Leigh Clark
Pediatric Otolaryngology
3705 Medical Pkwy Suite 200
Austin
, Texas 78705-1019
(512) 324-2720
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About
Features
Specialties
- Pediatric Otolaryngology
Languages spoken
- English
Location
First Address
- Dr. Stacey Leigh Clark
- 3705 Medical Pkwy Suite 200
- Austin, TX
- Zip : 78705-1019
- Phone : (512) 324-2720
Second Address
- Dr. Stacey Leigh Clark
- 3705 Medical Pkwy Suite 200
- Austin, TX
- Zip : 78705-1019
- Phone : (512) 324-2720
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207YP0228X | Pediatric Otolaryngology | N9190 | TX |
National Provider Identifier
| NPI | 1184808511 |
|---|---|
| Provider Name | Dr. Stacey Leigh Clark |
| First Address | Austin, TX 78705-1019 |
| Second Address | Austin, TX 78705-1019 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/12/2007 |
| Last Update Date | 30/01/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 285628801 | (05) | TX |
| 285628802 | (05) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.