Individual provider Active NPI

Lillian Wong

  • Internal Medicine Physician
  • Fort Worth, TX
National Provider Identifier
1295351260
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
BP10094357 Issued in TX
Practice address
900 8TH Ave
Fort Worth, TX 76104-3902
Phone
(817) 455-1143
NPI assigned
Jun 24, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X BP10094357 TX Primary

Addresses

Primary practice location

900 8TH Ave
Fort Worth, TX 76104-3902

Mailing address

452 S Rayner St
Fort Worth, TX 76111-1127

Other practice location 1

5323 Harry Hines Blvd
Dallas, TX 75390-7201
Phone (214) 648-3111

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250701000563 TX Order and Referring Only - Internal MedicinePractitioner - Internal Medicine 9133632375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BP10094357TXMDInternal Medicine Physician

Interoperability endpoints

  • Direct secure messaging: lillian.wong@hca7.eclinicaldirectplus.com

NPI Registry JSON

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

{
    "created_epoch": "1592956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1295351260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "452 S RAYNER ST",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761111127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043902",
            "telephone_number": "817-455-1143"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5323 Harry Hines Blvd",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "753907201",
            "country_code": "US",
            "telephone_number": "214-648-3111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "LILLIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-24",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "BP10094357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

Verify at the official NPI Registry.