Lisa Park, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

8206TG Issued in TX

Practice address

1428 W Hebron Pkwy Ste 125
Carrollton, TX 75010-6345

Phone

(972) 325-2022

NPI assigned

Jul 10, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA, TX2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/JBICCA

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.

• Lisa Park OD PLLC

  • Optometrist
  • Carrollton, TX
  • NPI 1396393385
  Medicare reassignment NPD Authorized official
• Mark Lynn OD & Associates, PC

  • Optometrist
  • Lithonia, GA
  • NPI 1417055203
  Medicare reassignment NPD
• Addison Internal Medicine PA

  • Internal Medicine Physician
  • Addison, TX
  • NPI 1437594462
  NPD

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

{
    "created_epoch": "1341878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662681600000",
    "number": "1134484785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 W HEBRON PKWY STE 125",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106345",
            "telephone_number": "972-325-2022",
            "fax_number": "972-332-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 W HEBRON PKWY STE 125",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106345",
            "telephone_number": "972-325-2022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARK",
        "first_name": "LISA",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-10",
        "last_updated": "2022-09-09",
        "certification_date": "2022-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "8206TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eloise Hyunji Park
• Hwan Joo Park, DDS
• Hye Ran Park, BCBA
• Julia Minju Park
• Kwonil Park, DDS
• Parker Trichology Centre
• David R Parker Jr., MD
• Harveer Singh Parmar, M.D.
• Angelita Ancheta Parrish, NP
• Cindy Lynne Parrish, M.S. CCC SLP

• Optometrist in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.