Individual provider Active NPI

Lilian Atieno Omburo, APRN

  • Family Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1326419318
Registry record updated Oct 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP128867 Issued in TX
Practice address
5323 Harry Hines Blvd
Dallas, TX 75390-7208
Phone
(214) 645-8800
Fax
(214) 645-8801
NPI assigned
Oct 15, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2015

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 AP128867 TX Primary

Addresses

Primary practice location

5323 Harry Hines Blvd
Dallas, TX 75390-7208

Mailing address

PO Box 845347
Dallas, TX 75284-5347

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160426000472 TX Practitioner - Nurse Practitioner 9739488735 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP128867TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Texas Southwestern Medical Center at Dallas CurrentSince Mar 19, 2016 Accepting new patients
The University of Texas Southwestern Medical Center at Dallas CurrentSince Mar 19, 2016 Accepting new patients
University of Texas Southwestern Medical Center at Dallas Current Accepting new patients

Locations

3000 N Interstate 35
Denton, TX 76201
Phone (469) 303-3591

600 S Main St
Ste 3900
Fort Worth, TX 76104
Phone (817) 882-2400

600 S Main St
Ft Worth, TX 76104
Phone (817) 882-2400

5323 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390

5303 Harry Hines Blvd
Ut Southwest Medical Center, TX 75390
Phone (214) 645-2300

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1326419318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 845347",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752845347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5323 HARRY HINES BLVD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753907208",
            "telephone_number": "214-645-8800",
            "fax_number": "214-645-8801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMBURO",
        "first_name": "LILIAN",
        "middle_name": "ATIENO",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-15",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP128867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.