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Mr. Kenneth Dale Clark
Orthotist in The Woodlands, Texas
NPI 1598046401

Kenneth Dale Clark is a Orthotist based in The Woodlands, TX. Kenneth Dale Clark practices in The Woodlands, TX. The NPI Number for Kenneth Dale Clark is 1598046401 and holds a License No. 400 (Texas).

The current practice location address for Kenneth Dale Clark is 9303 Pinecroft Dr, The Woodlands, TX and can be reached out via phone at 281-297-6445 and via fax at 281-297-6460.

Location: 9303 Pinecroft Dr, The Woodlands, TX, 77380-3181
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1598046401
Provider Name
Kenneth Dale Clark
Credential
Provider Entity Type
Individual
Gender
Male
Address
9303 Pinecroft Dr, The Woodlands, TX, 77380-3181
Phone Number
281-297-6445
Fax Number
281-297-6460
Provider Enumeration Date
09/06/2011
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
094010801 01 TX GROUP MEDICAID NUMBER
00J21A 01 TX GROUP MEDICARE NUMBER
institution
Provider Business Practice Location Address Details
Address
9303 Pinecroft Dr
City
The Woodlands
State
Texas
Zip
77380-3181
Phone Number
281-297-6445
Fax Number
281-297-6460
person
Provider Business Mailing Address Details
Address
9303 Pinecroft Dr
City
The Woodlands
State
Texas
Zip
77380-3181
Phone Number
281-297-6445
Fax Number
281-297-6460
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Orthotist
Speciality
-
Taxonomy
222Z00000X
License No.
400 (Texas)
Definition
A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care.
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