MR. FRUCTUEUX JUNIOR CLARK MD
NPI 1578400792
Student in an Organized Health Care Education/Training Program in Waco, TX

Q: What is Fructueux Clark's NPI number?

The NPI number for Fructueux Clark is 1578400792. It was assigned to this individual provider in the NPPES registry on May 4, 2026.

Q: What is Fructueux Clark's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Fructueux Clark was last updated on May 4, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since May 04, 2026

1600 PROVIDENCE DR, WACO, TX 76707(254) 313-4200(254) 313-4383 Get Directions Write a Review

NPPES record last updated: May 4, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

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About Mr. Fructueux Junior Clark Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. FRUCTUEUX JUNIOR CLARK MD (NPI 1578400792) is an individual student in an organized health care education/training program in Waco, Texas and active in the NPI registry since May 2026.

NPPES Registry Identity

NPI1578400792

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameMR. FRUCTUEUX JUNIOR CLARKCredential: MD

Location Address1600 PROVIDENCE DRWaco, TX 76707-2261

Mailing Address7907 Gerald DrAmarillo, TX 79121-1019 · (254) 313-4200 · Fax (254) 313-4383

Phone(254) 313-4200

Fax(254) 313-4383

Sole ProprietorNo

Enumeration DateMay 4, 2026

NPPES CertifiedMay 4, 2026

✔ NPI 1578400792 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

1600 PROVIDENCE DR, Waco, TX 76707

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALLISON L HULME MD

Family Medicine