Individual provider Active NPI

Tammy Nguyen, PA-C

  • Physician Assistant
  • Rockwall, TX
National Provider Identifier
1093281180
Registry record updated Feb 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA12275 Issued in TX
Practice address
3164 Horizon Rd # 100
Rockwall, TX 75032-7805
Phone
(972) 772-8767
NPI assigned
Oct 16, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA12275 TX Primary

Addresses

Primary practice location

3164 Horizon Rd # 100
Rockwall, TX 75032-7805

Mailing address

3129 Tres Logos LN
Dallas, TX 75228-1731
Phone (214) 708-7823

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tnguyen565850@direct.sw.org

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
I20181219000724 TX Practitioner - Physician Assistant 1456696400 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3500 Gaston Ave
FL 1
Dallas, TX 75246-2017
Phone (972) 817-6100

4001 Worth St
Dallas, TX 75246-1608

Hospital & facility affiliations

  • Baylor University Medical Center Hospital, Dallas, TX, CCN 450021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Mar 1, 2021 Accepting new patients
Healthtexas Provider Network CurrentSince Mar 1, 2021 Accepting new patients

Locations

3417 Gaston Ave
Ste 935
Dallas, TX 75246
Phone (469) 800-7680

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

3409 Worth St
Ste 600
Dallas, TX 75246
Phone (214) 820-6113

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

301 N Washington Ave
Dallas, TX 75246
Phone (469) 800-8330

1650 W College St
Ste 150
Grapevine, TX 76051
Phone (817) 338-3440

4510 Medical Center Dr
McKinney, TX 75069
Phone (214) 491-6365

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675728000000",
    "number": "1093281180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3129 TRES LOGOS LN",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752281731",
            "telephone_number": "214-708-7823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3164 HORIZON RD # 100",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750327805",
            "telephone_number": "972-772-8767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "TAMMY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-16",
        "last_updated": "2023-02-07",
        "certification_date": "2023-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12275",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tnguyen565850@direct.sw.org",
            "affiliation": "N",
            "address_1": "3417 Gaston Ave Ste 935",
            "city": "Dallas",
            "state": "TX",
            "country_code": "US",
            "postal_code": "752462036",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

Verify at the official NPI Registry.