Individual provider Active NPI

Lea Lopez-Fagin, FNP

  • Family Nurse Practitioner
  • Shavano Park, TX
National Provider Identifier
1306953385
Registry record updated Jun 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
428422 Issued in TX
Practice address
13409 NW Military Hwy
Suite 302
Shavano Park, TX 78231-1800
Phone
(210) 479-3297
Fax
(210) 479-3295
NPI assigned
Aug 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 428422 TX Primary

Addresses

Primary practice location

13409 NW Military Hwy
Suite 302
Shavano Park, TX 78231-1800

Mailing address

13409 NW Military Hwy
Suite 302
Shavano Park, TX 78231-1800
Phone (210) 479-3297

Other identifiers 1

IdentifierTypeStateIssuer
142765002MedicaidTX

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370304000000",
    "number": "1306953385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13409 NW MILITARY HWY",
            "address_2": "SUITE 302",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782311800",
            "telephone_number": "210-479-3297",
            "fax_number": "210-479-3295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13409 NW MILITARY HWY",
            "address_2": "SUITE 302",
            "city": "SHAVANO PARK",
            "state": "TX",
            "postal_code": "782311800",
            "telephone_number": "210-479-3297",
            "fax_number": "210-479-3295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOPEZ-FAGIN",
        "first_name": "LEA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-24",
        "last_updated": "2013-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "428422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "142765002",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shavano Park, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2013; 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.