Individual provider Active NPI

Annalysa H Nguyen, PA

  • Physician Assistant
  • Houston, TX
National Provider Identifier
1235118035
Registry record updated Feb 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05350 Issued in TX
Practice address
1140 Cypress Station Dr
Houston, TX 77090-3045
Phone
(281) 440-5300
Fax
(281) 440-8220
NPI assigned
Jan 11, 2006
Last updated
Feb 14, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 17197 CA
Physician Assistant 363A00000X PA05350 TX Primary

Addresses

Primary practice location

1140 Cypress Station Dr
Houston, TX 77090-3045

Mailing address

1140 Cypress Station Dr
Houston, TX 77090-3045
Phone (281) 440-5300

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
I20080303000358 TX Practitioner - Physician Assistant 0840246740 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Philadelphia College of Osteopathic Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Doctors Express of the Beaumont Area PAGroup PAC ID 5698816882, 211 clinicians

Practice addresses (Care Compare)

1448 Kingwood Dr
Kingwood, TX 77339-3040
Phone (281) 549-9007

8850 Spencer Hwy
La Porte, TX 77571-3736
Phone (281) 946-9980

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3249AZMDSpecialist
PA05350TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Southlake Doctors Express, PA PSC Current Accepting new patients
Ampla Health Past Accepting new patients
Baylor College of Medicine Past Accepting new patients
Ampla Health Past Accepting new patients
George Wang,MD,LLC Past Accepting new patients

Locations

2315 E Southlake Blvd
Ste 110
Southlake, TX 76092
Phone (817) 488-9922

Organizations & group practices 7

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": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739491200000",
    "number": "1235118035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 CYPRESS STATION DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903045",
            "telephone_number": "281-440-5300",
            "fax_number": "281-440-8220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 CYPRESS STATION DR",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770903045",
            "telephone_number": "281-440-5300",
            "fax_number": "281-440-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "ANNALYSA",
        "middle_name": "H",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-11",
        "last_updated": "2025-02-14",
        "certification_date": "2025-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "17197",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.