NPI age
5 years
Enumerated 2020-06-25
● Active
Type 1 · Individual
Jacob Alan Clark, MS, LAT, ATC
Clark is 1 of 4 specialist/technologist providers in Cisco and 1 of 2956 in Texas.
Primary specialty
Specialist/Technologist
Licensed in
TX
1 state
Status
Active
No deactivations on record
Last NPPES update
2020-06-25
Source: monthly bulk 2026-05
Sole proprietor
Yes
Solo practice on file
How this provider compares
Across 2956 active specialist/technologist providers in Texas.
NPI age
5 years
↓ 3 yr below median (8 yr)
State licenses
1 state
2% of peers hold multiple states
Subspecialties
0
13% of peers hold subspecialties
NPI lifetime · 2020 → 2026
2020-06Enumerated in NPPES
2020
2026
Where they practice
Practice location
101 College Hts
Cisco, TX 764371900
Mailing address
1645 Pr 2431
Clyde, TX 795101900
Specialties
-
Specialist/Technologist PrimaryAthletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently,...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | JEA013107880 | BLUECROSS BLUESHIELD |
Practice context
Part of a multi-provider practice. 1 other active provider shares this practice address in NPPES.
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- 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.