Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Keith Wayne Clark, PTA

Individual provider Physical Therapy Assistant · NPI 1346739737

Keith Wayne Clark, PTA is a Physical Therapy Assistant in Winnsboro, Texas. Licensed in Maryland, New Hampshire, Texas and Virginia and 1 more. Registered with an NPI since 2018.

Licensed in
MD, NH, TX, VA, VT
In the registry since
2018
Specialties on file
5
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

406 S Main St
Winnsboro, TX 75494-3226
Phone: (903) 342-6790
Fax: (903) 342-6796
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 2015517 (TX)
Physical Therapy Assistant Taxonomy 225200000X · Licence CP022392A (MD)
Physical Therapy Assistant Taxonomy 225200000X · Licence 1445 (NH)
Physical Therapy Assistant Taxonomy 225200000X · Licence 041.0134009 (VT)
Physical Therapy Assistant Taxonomy 225200000X · Licence CP026481A (VA)

Record details

NPI number1346739737
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedMay 1, 2018
Last updated in NPPESJuly 12, 2024
Certification dateJuly 8, 2024
Mailing address303 Pamela Dr, Mineola, TX 75773-1327

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