Punnam Stephan, APRN, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Lavon, TX
NPI 1104245984 · NPPES record last updated May 28, 2026
Key facts
- NPI
- 1104245984
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- AP125397 (TX)
- Practice address
- 845 S State Hwy 78
Ste 150
Lavon, TX 75166 - Phone
- (972) 532-6214
- NPI assigned
- Apr 9, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Healthtexas Provider Network
Legacy Healthcare Services Inc
Practice addresses (Care Compare)
3600 Gaston Ave
Suite 656
Dallas, TX 75246-1906
Phone (214) 820-3466
800 College Pkwy
Lewisville, TX 75077-3503
Phone (972) 420-8543
845 S State Hwy 78
Suite 150
Lavon, TX 75166
Phone (972) 532-6214
Hospital & facility affiliations
- Baylor Scott and White Medical Center Lake Pointe
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140620000722 | TX | Practitioner - Nurse Practitioner | 0941424550 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Wellness Station LLC | Current |
Accepting new patients | |
| Healthtexas Provider Network | Current |
Accepting new patients | |
| Healthtexas Provider Network | Current |
Accepting new patients | |
| Healthtexas Provider Network | Current | Accepting new patients | |
| Century Integrated Partners, Inc | Current |
Accepting new patients | |
| Healthtexas Provider Network | Past | Accepting new patients |
Locations
5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920
4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665
3500 Gaston Ave
Dallas, TX 75246
3600 Gaston Ave
Ste 550
Dallas, TX 75246
Phone (214) 821-1177
3600 Gaston Ave
Ste 656
Dallas, TX 75246
Phone (214) 820-3466
4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745
1400 8th Ave
Ft Worth, TX 76104
Phone (817) 922-1559
845 State Highway 78
Ste 150
Lavon, TX 75166
Phone (972) 532-6214
5252 W University Dr
McKinney, TX 75071
Phone (469) 764-1000
4700 Alliance Blvd
#P
Plano, TX 75093
Phone (469) 814-2000
821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200
7501 Lakeview Pkwy
Ste 220
Rowlett, TX 75088
Phone (469) 800-2475
Interoperability endpoints
- pstephan225847@direct.sw.org
- https://fhir4.healow.com/fhir/r4/AFHAED/Endpoint/AFHAED
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | AP125397 | TX | Yes |
Addresses
Primary practice location
845 S State Hwy 78
Ste 150
Lavon, TX 75166
Mailing address
845 S State Hwy 78
Ste 150
Lavon, TX 75166
Phone (972) 532-6214
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3401879-04 | Medicaid | TX |
Other providers in Lavon, TX
- Royal Passion Homehealth Care Services Inc
- Griselda Ruvalcaba
- Julia Smith
- Shaquita Spearman
- Star Spangled Smiles
- Alanna Stewart
- The Compassion Hospice Care LLC
- The Wellness Station LLC
- Triple J Home Healthcare Inc
- Vuong LLC
All providers in Lavon, TX · Family Nurse Practitioner in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 28, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.