Individual provider Active NPI

Lisa Nguyen, PA

  • Physician Assistant
  • Flower Mound, TX
National Provider Identifier
1083942817
Registry record updated Aug 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA06372 Issued in TX
Practice address
1100 Flower Mound Rd
Flower Mound, TX 75028-3503
Phone
(972) 874-8421
Fax
(972) 874-8467
NPI assigned
Dec 7, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 30, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA06372 TX
Physician Assistant 363A00000X PA06372 TX Primary

Addresses

Primary practice location

1100 Flower Mound Rd
Flower Mound, TX 75028-3503

Mailing address

1100 Flower Mound Rd
Flower Mound, TX 75028-3503
Phone (972) 874-8421

Other identifiers 1

IdentifierTypeStateIssuer
PA06372OtherTXSTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100108000681 TX Practitioner - Physician Assistant 2264573575 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DCS Medical PAGroup PAC ID 0042507600, 155 clinicians

Practice addresses (Care Compare)

12628 Timberland Blvd
Fort Worth, TX 76244-5528
Phone (817) 380-3720

3201 University Dr E
135 Integrity Urgent Care
Bryan, TX 77802-3481
Phone (979) 703-1832

371 Mercedes St
Benbrook, TX 76126-2593
Phone (817) 448-8114

607 E Malloy Bridge Rd
Seagoville, TX 75159-1817
Phone (469) 908-5018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
DCS Medical PA CurrentSince Feb 28, 2024 Accepting new patients
DCS Medical PA CurrentSince Feb 28, 2024 Accepting new patients
DCS Medical PA Past Accepting new patients

Locations

3201 University Dr E
Ste 135
Bryan, TX 77802
Phone (979) 703-1832

3010 E Business 190
Ste 254
Copperas Cove, TX 76522
Phone (254) 577-5642

607 E Malloy Bridge Rd
Seagoville, TX 75159
Phone (469) 908-5018

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1260144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472515200000",
    "number": "1083942817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 FLOWER MOUND RD",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750283503",
            "telephone_number": "972-874-8421",
            "fax_number": "972-874-8467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 FLOWER MOUND RD",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "750283503",
            "telephone_number": "972-874-8421",
            "fax_number": "972-874-8467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LISA",
        "credential": "PA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-07",
        "last_updated": "2016-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA06372",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA06372",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "PA06372",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flower Mound, TX

Sources for this page

Verify at the official NPI Registry.