Active NPI
Lianne Bencomo Tejeiro
- Physician Assistant
- Sunnyvale, TX
National Provider Identifier
1124806880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA17533
- Practice address
- 2820 N Belt Line Rd Ste 100
Sunnyvale, TX 75182-9304 - Phone
- (972) 288-6189
- NPI assigned
- Sep 14, 2023
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA17533 | TX | Primary |
Addresses
Primary practice location
2820 N Belt Line Rd Ste 100
Sunnyvale, TX 75182-9304
Mailing address
2820 N Belt Line Rd Ste 100
Sunnyvale, TX 75182-9304
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA17533 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1694649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709856000000",
"number": "1124806880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2820 N BELT LINE RD STE 100",
"city": "SUNNYVALE",
"state": "TX",
"postal_code": "751829304"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2820 N BELT LINE RD STE 100",
"city": "SUNNYVALE",
"state": "TX",
"postal_code": "751829304",
"telephone_number": "972-288-6189"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENCOMO TEJEIRO",
"first_name": "LIANNE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-09-14",
"last_updated": "2024-03-08",
"certification_date": "2024-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA17533",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sunnyvale, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.