Individual provider Active NPI

Punnam Stephan, APRN, FNP-C

  • Family Nurse Practitioner
  • Lavon, TX
National Provider Identifier
1104245984
Registry record updated May 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP125397 Issued in TX
Practice address
845 S State Hwy 78
Ste 150
Lavon, TX 75166
Phone
(972) 532-6214
NPI assigned
Apr 9, 2014
Last updated
May 28, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP125397 TX Primary

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

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
I20140620000722 TX Practitioner - Nurse Practitioner 0941424550 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
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 NetworkGroup PAC ID 1355254210, 2,535 clinicians
Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP125397TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
The Wellness Station LLC CurrentSince Nov 22, 2025 Accepting new patients
Healthtexas Provider Network CurrentSince Oct 15, 2018 Accepting new patients
Century Integrated Partners, Inc CurrentSince Jan 1, 2016 Accepting new patients
Healthtexas Provider Network Current Accepting new patients
Healthtexas Provider Network CurrentSince Oct 15, 2018 Accepting new patients
Healthtexas Provider Network Past Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

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

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

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

  • FHIR API: https://fhir4.healow.com/fhir/r4/AFHAED/Endpoint/AFHAED
  • Direct secure messaging: pstephan225847@direct.sw.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1397001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779926400000",
    "number": "1104245984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "845 S STATE HWY 78",
            "address_2": "STE 150",
            "city": "LAVON",
            "state": "TX",
            "postal_code": "75166",
            "telephone_number": "972-532-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "845 S STATE HWY 78",
            "address_2": "STE 150",
            "city": "LAVON",
            "state": "TX",
            "postal_code": "75166",
            "telephone_number": "972-532-6214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEPHAN",
        "first_name": "PUNNAM",
        "credential": "APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-09",
        "last_updated": "2026-05-28",
        "certification_date": "2026-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP125397",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lavon, TX

Sources for this page

Verify at the official NPI Registry.