Individual provider Active NPI

Lai King Jessica Mo NG, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1174336226
Registry record updated Jul 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA18579 Issued in TX
Practice address
3600 Gaston Ave Ste 960
Dallas, TX 75246-1909
Phone
(214) 820-2346
NPI assigned
Jan 30, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 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 PA18579 TX Primary

Addresses

Primary practice location

3600 Gaston Ave Ste 960
Dallas, TX 75246-1909

Mailing address

3600 Gaston Ave Ste 960
Dallas, TX 75246-1909
Phone (214) 820-2346

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
I20250807001077 TX Practitioner - Physician Assistant 8325546682 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bianco Brain and Spine, LLCGroup PAC ID 8426103243, 5 clinicians
The West Texas Rehabilitation CenterGroup PAC ID 2860301215, shared by 5 NPIs, 444 clinicians

Practice addresses (Care Compare)

2705 W Arkansas LN
Dalworthington Gardens, TX 76016-5818
Phone (817) 701-4253

4601 Hartford St
Abilene, TX 79605-4603
Phone (325) 793-3411

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA18579TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bianco Brain & Spine, LLC CurrentSince Jan 11, 2026 Accepting new patients
Healthtexas Provider Network CurrentSince Jul 28, 2025 Accepting new patients

Locations

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

3600 Gaston Ave
Ste 960
Dallas, TX 75246
Phone (214) 820-5630

2705 W Arkansas Ln
Dwg, TX 76016
Phone (817) 701-4253

Interoperability endpoints

  • Direct secure messaging: lmong1428000@direct.sw.org

Organizations & group practices 3

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.

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": "1738195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752105600000",
    "number": "1174336226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE STE 960",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461909",
            "telephone_number": "214-820-2346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 GASTON AVE STE 960",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461909",
            "telephone_number": "214-820-2346"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MO NG",
        "first_name": "LAI KING",
        "middle_name": "JESSICA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-30",
        "last_updated": "2025-07-10",
        "certification_date": "2025-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA18579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.