Individual provider Active NPI

Angselee Lyzandra Bibb-Serrano, LVN

  • Licensed Practical Nurse
  • Pflugerville, TX
National Provider Identifier
1265996664
Registry record updated Jan 30, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
202994 Issued in TX
Practice address
14921 Sassafras TRL
Pflugerville, TX 78660-3022
Phone
(512) 577-8083
NPI assigned
Jan 30, 2019
Last updated
Jan 30, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 202994 TX Primary

Addresses

Primary practice location

14921 Sassafras TRL
Pflugerville, TX 78660-3022

Mailing address

14921 Sassafras TRL
Pflugerville, TX 78660-3022
Phone (512) 577-8083

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
202994TXMDLicensed Practical Nurse

NPI Registry JSON

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548806400000",
    "number": "1265996664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14921 SASSAFRAS TRL",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786603022",
            "telephone_number": "512-577-8083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14921 SASSAFRAS TRL",
            "city": "PFLUGERVILLE",
            "state": "TX",
            "postal_code": "786603022",
            "telephone_number": "512-577-8083"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIBB-SERRANO",
        "first_name": "ANGSELEE",
        "middle_name": "LYZANDRA",
        "credential": "LVN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-30",
        "last_updated": "2019-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "TX",
            "license": "202994",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pflugerville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.