Active NPI
Laura Jean Watson, PA
- Physician Assistant
- Dallas, TX
National Provider Identifier
1235192535
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA04317
- Practice address
- 4500 S Lancaster Rd
Dallas, TX 75216-7167 - Phone
- (214) 857-2244
- NPI assigned
- Apr 8, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA04317 | TX | Primary |
Addresses
Primary practice location
4500 S Lancaster Rd
Dallas, TX 75216-7167
Mailing address
4500 S Lancaster Rd
Dallas, TX 75216-7167
Phone (214) 857-2244
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00269398 | Other | TX | RR/MEDICARE |
| 8N9139 | Other | TX | BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA04317 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1266537600000",
"number": "1235192535",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4500 S LANCASTER RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752167167",
"telephone_number": "214-857-2244"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 S LANCASTER RD",
"city": "DALLAS",
"state": "TX",
"postal_code": "752167167",
"telephone_number": "214-857-2244"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATSON",
"first_name": "LAURA",
"middle_name": "JEAN",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-08",
"last_updated": "2010-02-19",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA04317",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR/MEDICARE",
"identifier": "P00269398",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "8N9139",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2010; 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.