Edward Deallen Clark, MD in Grapevine, TX - Medicare Obstetrics & Gynecology

Edward Deallen Clark, MD is a medicare enrolled "Obstetrics & Gynecology" physician in Grapevine, Texas. His current practice location is 1600 W College St Ste Ll10, Grapevine, Texas. You can reach out to his office (for appointments etc.) via phone at (817) 410-7982.

Edward Deallen Clark is licensed to practice in Texas (license number K3564) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1730294232.

Contact Information

	Edward Deallen Clark, MD
	1600 W College St Ste Ll10, Grapevine, TX 76051-3598
	(817) 410-7982
	(817) 410-7986

Map and Direction

Physician's Profile

Full Name	Edward Deallen Clark
Gender	Male
Speciality	Obstetrics & Gynecology
Location	1600 W College St Ste Ll10, Grapevine, Texas
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1730294232
Provider Enumeration Date: 08/21/2006
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 1658661525
Enrollment ID: I20160606000494

Medical Identifiers

Medical identifiers for Edward Deallen Clark such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1730294232	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207V00000X	Obstetrics & Gynecology	K3564 (Texas)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Edward Deallen Clark allows following entities to bill medicare on his behalf.

Entity Name	Longview Wellness Center Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1942269493 PECOS PAC ID: 1254367766 Enrollment ID: O20050714001046

Entity Name	Obhg Texas Holdings Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1083917769 PECOS PAC ID: 3577713072 Enrollment ID: O20121018000279

Entity Name	Arlington Physician Services Pa
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1093144610 PECOS PAC ID: 8224256961 Enrollment ID: O20140821002133

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Edward Deallen Clark is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Edward Deallen Clark, MD 1600 W College St Ste Ll10, Grapevine, TX 76051-3598 Ph: (817) 410-7982	Edward Deallen Clark, MD 1600 W College St Ste Ll10, Grapevine, TX 76051-3598 Ph: (817) 410-7982

Reviews and Comments

Obstetrics & Gynecology Doctors in Grapevine, TX

Mrs. Sofia Ana Lieser, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1600 W College St Ste 540, Grapevine, TX 76051 Phone: 817-481-5863 Fax: 817-329-8561
Michael N Sims, MD Obstetrics & Gynecology Medicare: Medicare Enrolled Practice Location: 1600 W College St, #540, Grapevine, TX 76051 Phone: 817-481-5863 Fax: 817-329-8561
Robert B Wai, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1600 W College, #540, Grapevine, TX 76051 Phone: 817-481-5863 Fax: 817-329-8561
Dr. Angelo C Mendez, M.D. Obstetrics & Gynecology Medicare: Not Enrolled in Medicare Practice Location: 1600 W College St, Ste 340, Grapevine, TX 76051 Phone: 817-329-0389 Fax: 817-421-1416
Doreen A Moser, D.O. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1600 W College St, Ste 260, Grapevine, TX 76051 Phone: 817-310-3775
Carrie Phelps Morris, MD Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1600 W College St, Ste 540, Grapevine, TX 76051 Phone: 817-481-5863 Fax: 817-329-8561
Dr. Timothy J Rost, M.D. Obstetrics & Gynecology Medicare: Accepting Medicare Assignments Practice Location: 1600 W College St, Ste 340, Grapevine, TX 76051 Phone: 817-329-0389 Fax: 817-421-1416

Edward Deallen Clark, MD - Medicare Obstetrics & Gynecology in Grapevine, TX