Provider Demographics
NPI:1821292517
Name:CLARK, STEVEN ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ANTHONY
Last Name:CLARK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4510 MEDICAL CENTER DR
Mailing Address - Street 2:SUITE 305
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-1650
Mailing Address - Country:US
Mailing Address - Phone:469-675-3659
Mailing Address - Fax:469-675-3181
Practice Address - Street 1:4510 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 305
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-1650
Practice Address - Country:US
Practice Address - Phone:469-675-3659
Practice Address - Fax:469-675-3181
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-14
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN35672086S0122X, 2082S0105X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand