Liza De Olazo Banaag, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

K5793 Issued in TX

Practice address

17218 Preston Rd # 2000
Dallas, TX 75252-4018

Phone

(877) 866-7123

NPI assigned

Aug 7, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family PracticeAlso: Peripheral Vascular Disease

Education

Other, 1982

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vohra Post Acute Care Physicians of Texas, PLLCGroup PAC ID 0042447682, 41 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Vohra Post Acute Care Physicians of Texas, PLLC

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1821424789
  Medicare reassignment Care Compare group NPD
• Utmb Faculty Group Practice

  • General Practice Physician
  • Galveston, TX
  • NPI 1942241146
  Medicare reassignment NPD
• Liza de Olazo Banaag, M. D., P. a.

  • Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
  • Grenada, MS
  • NPI 1558497040
  NPD Authorized official

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687132800000",
    "number": "1194916874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 742712",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303742712",
            "telephone_number": "877-866-7123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17218 PRESTON RD # 2000",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752524018",
            "telephone_number": "877-866-7123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANAAG",
        "first_name": "LIZA",
        "middle_name": "DE OLAZO",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2023-06-19",
        "certification_date": "2023-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2083P0011X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Undersea and Hyperbaric Medicine",
            "state": "TX",
            "license": "K5793",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K5793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "096334004",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.