P Praxis·MD
● Active Type 1 · Individual

DR. Clinton Sangkyu Park, M.D.

Radiology·Fort Worth, TX· NPI 1295932242 · Enumerated 2007 · 18 years on NPI
Park is 1 of 13 radiology providers in Fort Worth and 1 of 568 in Texas.
NPI age
18 years
Enumerated 2007-07-02
Primary specialty
Radiology
Plus 1 subspecialty
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2021-12-09
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 568 active radiology providers in Texas.

NPI age
18 years
≈ at median (18 yr)
State licenses
1 state
18% of peers hold multiple states
Subspecialties
1
In the 31% of peers with subspecialties

NPI lifetime · 2007 → 2026

2007-07Enumerated in NPPES
2007 2026

Where they practice

Practice location
500 S Henderson St Ste 200
Fort Worth, TX 761042154
📞 8174131500fax 8174131499
Mailing address
Po Box 911230
Dallas, TX 753911230
📞 9729978000fax 9722342987

Specialties

  • Radiology Primary
    A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors.
    TX license #N3228 taxonomy 2085R0001X
  • Radiology
    Therapeutic Radiology certificate name was changed to Radiation Oncology. Use Radiation Oncology.
    TX license #BP10022820 taxonomy 2085R0203X

Identifiers

TypeValueNotes
01 (TX) P00764078 RAILROAD MEDICARE
01 (TX) 8CA240 BLUECROSS BLUESHIELD OF TEXAS
05 (TX) 202476201
05 (TX) 202476202

Practice context

Part of a multi-provider practice. 19 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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