Individual provider Active NPI

Jennifer Nguyen

  • Physician Assistant
  • Plano, TX
National Provider Identifier
1164228508
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA19312 Issued in TX
Practice address
6300 W Parker Rd Ste G20
Plano, TX 75093-8105
Phone
(972) 468-9999
Fax
(972) 981-3600
NPI assigned
Feb 24, 2025
Last updated
Jun 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA19312 TX Primary

Addresses

Primary practice location

6300 W Parker Rd Ste G20
Plano, TX 75093-8105

Mailing address

6300 W Parker Rd Ste G20
Plano, TX 75093-8105
Phone (972) 468-9999

Other practice location 1

1080 W Campbell Rd Ste 100
Richardson, TX 75080-2989
Phone (469) 458-7999

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
I20250724003116 TX Practitioner - Physician Assistant 3072020122 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arash Tirandaz MD PA Current Accepting new patients

Locations

6124 W Parker Rd
Ste 234
Plano, TX 75093
Phone (972) 468-9999

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1740355200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1164228508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 W PARKER RD STE G20",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938105",
            "telephone_number": "972-468-9999",
            "fax_number": "972-981-3600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 W PARKER RD STE G20",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750938105",
            "telephone_number": "972-468-9999",
            "fax_number": "972-981-3600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1080 W Campbell Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Richardson",
            "state": "TX",
            "postal_code": "750802989",
            "country_code": "US",
            "telephone_number": "469-458-7999",
            "fax_number": "972-981-3600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-02-24",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA19312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plano, TX

Sources for this page

Verify at the official NPI Registry.