NPI age
16 years
Enumerated 2009-11-19
● Active
Type 1 · Individual
Shannon Clark
Clark is 1 of 9 specialist/technologist providers in Round Rock and 1 of 3379 in Texas.
Primary specialty
Specialist/Technologist
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2009-11-19
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 3379 active specialist/technologist providers in Texas.
NPI age
16 years
↑ 9 yr above median (7 yr)
State licenses
1 state
0% of peers hold multiple states
Subspecialties
0
2% of peers hold subspecialties
NPI lifetime · 2009 → 2026
2009-11Enumerated in NPPES
2009
2026
Where they practice
Practice location
1208 Ih 35 N Ste Q
Round Rock, TX 786814204
Mailing address
1208 Ih 35 N Ste Q
Round Rock, TX 786814204
Specialties
-
Specialist/Technologist PrimaryDefinition to come...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (TX) | 0944746-02 | |
| 01 | 0031DG | BLUE CROSS BLUE SHIELD |
| 01 | 74-2745294 | TAX ID |
Practice context
Part of a multi-provider practice. 10 other active providers share this practice address in NPPES.
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Request a quote →How to verify this provider
- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
- Check the state license is currently active.State licensing boards publish current status; NPPES does not.
- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.