Angel's Star Wellness Center, P.a

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

L0508 Issued in TX

Legal business name

ANGEL'S STAR WELLNESS CENTER, P.A

Practice address

8325 Whitley Rd
Suite: 100
Watauga, TX 76148-2487

Phone

(817) 479-1181

Fax

(817) 918-4432

NPI assigned

Dec 12, 2006

Last updated

Oct 20, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Frank Nguyen

Title

Management

Phone

(817) 791-1811

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Chau N Pham, DO

  • Family Medicine Physician
  • Watauga, TX
  • NPI 1881659381
  Medicare reassignment NPD
• Michelle Flores-Pitogo, APN

  • Family Medicine Physician
  • Watauga, TX
  • NPI 1225679715
  NPD
• Jennifer Duyen Trinh, D.O.

  • Family Medicine Physician
  • Watauga, TX
  • NPI 1770943177
  NPD

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634688000000",
    "number": "1457412710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8325 WHITLEY RD",
            "address_2": "SUITE: 100",
            "city": "WATAUGA",
            "state": "TX",
            "postal_code": "761482487",
            "telephone_number": "817-479-1181",
            "fax_number": "817-750-2789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8325 WHITLEY RD",
            "address_2": "SUITE: 100",
            "city": "WATAUGA",
            "state": "TX",
            "postal_code": "761482487",
            "telephone_number": "817-479-1181",
            "fax_number": "817-918-4432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGEL'S STAR WELLNESS CENTER, P.A",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-12",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "FRANK",
        "authorized_official_title_or_position": "MANAGEMENT",
        "authorized_official_telephone_number": "817-791-1811"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "L0508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0072PD",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "DH2407",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "191341001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Watauga, TX
• Providers in Watauga, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.