Jackie Leah Clark, PHD
NPI 1417951484ActiveIndividual· Audiologist· Tool, TX
Audiologist (PHD) with University of Texas at Dallas, practicing in Tool, Texas. Enrolled in Medicare as practitioner - qualified audiologist.
Overview
| NPI | 1417951484 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PHD |
| Sole proprietor | Yes |
| NPI issued | Jun 8, 2005 |
| Last updated in NPPES | Oct 28, 2020 |
| Certified by provider | Oct 28, 2020 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Audiologist Primary | 231H00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Qualified Audiologist (TX) |
|---|
Education and affiliations
| Graduation year | 1995 |
|---|---|
| Medicare specialty | Qualified Audiologist |
Medical group
- University of Texas at DallasDallas, TX · 6 clinicians
Other audiologists in Tool
- 1780225631