Active NPI
Sophie Lung
- Pediatrics Physician
- Shenandoah, TX
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- N1745
- Practice address
- 106 Vision Park Blvd
Shenandoah, TX 77384-3000 - Phone
- (713) 442-1800
- NPI assigned
- Jul 9, 2009
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | N1745 | TX | Primary |
Addresses
Primary practice location
106 Vision Park Blvd
Shenandoah, TX 77384-3000
Mailing address
11511 Shadow Creek Pkwy
Pearland, TX 77584-7298
Phone (713) 442-0000
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 204041204 | Medicaid | TX | |
| 204041202 | Medicaid | TX | |
| 204041203 | Medicaid | TX |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| FHIR URL | https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/ | Health Information Exchange (HIE) | |
| Direct Messaging Address | slung4928@direct.kelsey-seybold.com | Direct |
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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kelsey-Seybold Medical Group, PLLC | Pediatrics | Current | Accepting new patients |
| TCH Pediatric Associates, Inc | Pediatrics | Past | Accepting new patients |
Locations
2727 W Holcombe Blvd
Houston, TX 77025
Phone (713) 790-9412
7010 Highway 6
Missouri City, TX 77459
Phone (713) 442-4200
11511 Shadow Creek Pkwy
Pearland, TX 77584
Phone (713) 442-4997
2515 Business Center Dr
Pearland, TX 77584
Phone (713) 442-7200
106 Vision Park Blvd
Shenandoah, TX 77384
Phone (713) 442-1800
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Houston, TX
- NPI 1013915255
Pediatrics
-
- Pediatrics Physician
- Houston, TX
- NPI 1225038326
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623283200000",
"number": "1285863449",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11511 SHADOW CREEK PKWY",
"city": "PEARLAND",
"state": "TX",
"postal_code": "775847298",
"telephone_number": "713-442-0000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "106 VISION PARK BLVD",
"city": "SHENANDOAH",
"state": "TX",
"postal_code": "773843000",
"telephone_number": "713-442-1800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUNG",
"first_name": "SOPHIE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-07-09",
"last_updated": "2021-06-10",
"certification_date": "2021-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "TX",
"license": "N1745",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "204041204",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "204041202",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "204041203",
"state": "TX"
}
],
"endpoints": [
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://ssrx.ksnet.com/FhirProxy/api/FHIR/DSTU2/",
"affiliation": "N",
"endpointDescription": "FHIR endpoint URL",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "106 Vision Park Blvd",
"city": "Shenandoah",
"state": "TX",
"country_code": "US",
"postal_code": "773843000",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "slung4928@direct.kelsey-seybold.com",
"affiliation": "N",
"endpointDescription": "digital contact information",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "106 Vision Park Blvd",
"city": "Shenandoah",
"state": "TX",
"country_code": "US",
"postal_code": "773843000",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Shenandoah, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.