Active NPI
Jeannette Marie Olazagasti Lourido, M.D., M.S.
- Dermatology Physician
- Euless, TX
National Provider Identifier
1104288778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- T0879
- Practice address
- 601 Westpark Way Ste 100
Euless, TX 76040-3972 - Phone
- (817) 754-8884
- Fax
- (817) 977-9077
- NPI assigned
- Mar 23, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | T0879 | TX | Primary |
Addresses
Primary practice location
601 Westpark Way Ste 100
Euless, TX 76040-3972
Mailing address
601 Westpark Way Ste 100
Euless, TX 76040-3972
Phone (817) 754-8884
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 1, 2025 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Master of Science
Interoperability endpoints
- lourido@conger.emadirect.md
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1700870400000",
"number": "1104288778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 WESTPARK WAY STE 100",
"city": "EULESS",
"state": "TX",
"postal_code": "760403972",
"telephone_number": "817-754-8884",
"fax_number": "817-977-9077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "601 WESTPARK WAY STE 100",
"city": "EULESS",
"state": "TX",
"postal_code": "760403972",
"telephone_number": "817-754-8884",
"fax_number": "817-977-9077"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OLAZAGASTI LOURIDO",
"first_name": "JEANNETTE",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "M.D., M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-03-23",
"last_updated": "2023-11-25",
"certification_date": "2023-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "TX",
"license": "T0879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Euless, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.