ROBERT JEFF CLARK, BS, CNIM — NPI 1336357045 (Licensed & Credentialed Specialist/Technologist, Other, Electroneurodiagnostic in LINDALE, TX)

CMS-1500 Box 24J / 33a • NPI

1336357045

Type 1 Individual Rendering/Ordering

HIPAA NUCC Taxonomy • CMS Code

246ZE0600X

Licensed & Credentialed Specialist/Technologist, Other, Electroneurodiagnostic

Box 32 Service Location & ZIP+4

14983 BOAZ LN, LINDALE, TX, 75771-4801

✓ 9-Digit EDI 837 ZIP+4 (75771-4801)

Practice Phone & Referral Fax

(972) 786-6167

Fax: (903) 882-7748

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1336357045 (ROBERT JEFF CLARK, BS, CNIM) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

This practitioner does not currently appear in the CMS individual Order & Referring PECOS file (may practice in pediatrics, commercial-only networks, or hospital-employed settings).

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1336357045` (NPI-1 Individual Practitioner)
Provider / Legal Name	ROBERT JEFF CLARK, BS, CNIM
Plain-English Specialty	Licensed & Credentialed Specialist/Technologist, Other, Electroneurodiagnostic NUCC Code: `246ZE0600X` (Specialist/Technologist, Other, Electroneurodiagnostic)
Certifying / Licensing Body	State Medical / Healthcare Licensing Board & National Specialty Board
Practice Location Address	14983 BOAZ LN, LINDALE, TX, 75771-4801
Practice Telephone / Fax	Tel: (972) 786-6167 \| Fax: (903) 882-7748
Administrative Mailing Address	14983 BOAZ LN, LINDALE, TX, 75771-4801
Enumeration & Last Sync	Enumerated: 2007-05-18 \| CMS Record Updated: 2021-09-02

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

14983 BOAZ LN, LINDALE, TX, 75771-4801

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Plain-English Taxonomy & CMS Crosswalk (246ZE0600X)

What Does Taxonomy Code 246ZE0600X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 246ZE0600X translates to:
"Licensed & Credentialed Specialist/Technologist, Other, Electroneurodiagnostic"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: State Medical / Healthcare Licensing Board & National Specialty Board
Clinical Scope: Consult a verified Specialist/Technologist, Other, Electroneurodiagnostic for specialized diagnostic evaluation, treatment planning, and continuity of care.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (ROBERT JEFF CLARK, BS, CNIM)

Typical CPT / Diagnostic Procedures:

Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
Preventive Screening, Patient Counseling & Multidisciplinary Referral

Common Therapeutic Classes:

Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`246ZE0600X` — Specialist/Technologist, Other, Electroneurodiagnostic Plain English: Licensed & Credentialed Specialist/Technologist, Other, Electroneurodiagnostic	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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ROBERT JEFF CLARK, BS, CNIM (NPI #1336357045)