Lifestream Health Center PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

H6110 Issued in TX

Legal business name

LIFESTREAM HEALTH CENTER PA

Practice address

705 Main St
Coppell, TX 75019-4742

Phone

(972) 304-6400

Fax

(972) 304-6455

NPI assigned

May 4, 2009

Last updated

Mar 29, 2016By the provider in NPPES

Organization subpart

Yes

Parent organization

LIFESREAM HEALTH CENTER PAAs reported in NPPES

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

Authorized official

Name

Dr. Brandon C Charles, M.D.NPI 1609833276

Title

President

Phone

(972) 304-6400

Specialties & licenses 1

Addresses

Other identifiers 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Part of

Lifestream Health Center PA

Locations

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brandon C Charles, MD

  • Obstetrics & Gynecology Physician
  • Coppell, TX
  • NPI 1609833276
  NPD (past) Authorized official
• Sharolyn K. Dihigo, DNP, RN, CPNP, FNP-C

  • Family Nurse Practitioner
  • Coppell, TX
  • NPI 1366447211
  NPD (past)
• Scharlene Kay Gaudet, DC, DACNB

  • Neurology Chiropractor
  • Coppell, TX
  • NPI 1962879015
  NPD (past)
• Susan R. Harris, CNM, FNP-C

  • Family Nurse Practitioner
  • Coppell, TX
  • NPI 1407912827
  NPD (past)
• Jana Elisabeth Rogers, FNP-C

  • Family Nurse Practitioner
  • Coppell, TX
  • NPI 1598341588
  NPD (past)
• Lori B Spors

  • Primary Care Nurse Practitioner
  • Coppell, TX
  • NPI 1154976538
  NPD (past)
• Michael D Sullivan, PA

  • Physician Assistant
  • Coppell, TX
  • NPI 1689707515
  NPD (past)
• Julie Carol Murphy, CNP

  • Women's Health Nurse Practitioner
  • Scottsdale, AZ
  • NPI 1396178398
  NPD (past)

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

{
    "created_epoch": "1241395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1235363409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 MAIN STREET",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "75019",
            "telephone_number": "972-304-6400",
            "fax_number": "972-304-6455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 MAIN ST",
            "city": "COPPELL",
            "state": "TX",
            "postal_code": "750194742",
            "telephone_number": "972-304-6400",
            "fax_number": "972-304-6455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTREAM HEALTH CENTER PA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIFESREAM HEALTH CENTER PA",
        "enumeration_date": "2009-05-04",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "CHARLES",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "972-304-6400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "TX",
            "license": "H6110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS MEDICAL BOARD LICENSE",
            "identifier": "H6110",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Legacy Apothecary LP (ReNue Rx #12- LTC)
• Rosa Lemus
• Abigail Lesko, PT, DPT
• Matleena Elisabeth Leslie, MSN, APRN, WHNP-BC
• Monica Lewis, LMT
• Joshua Link
• Ania J. Linkiewicz-Gawel, MD
• Lisa C McElroy PHD PLLC
• Living Euphoria, LLC
• Llrac Surgical Associates, PLLC

• Specialist in Coppell, TX
• Providers in Coppell, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.