Individual provider Active NPI

Liliana Espinoza, PA

  • Physician Assistant
  • Desoto, TX
National Provider Identifier
1467647669
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA05360 Issued in TX
Practice address
951 York Dr Ste 102
Desoto, TX 75115-2052
Phone
(972) 296-5557
Fax
(972) 296-5592
NPI assigned
Sep 11, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA05360 TX Primary

Addresses

Primary practice location

951 York Dr Ste 102
Desoto, TX 75115-2052

Mailing address

951 York Dr Ste 102
Desoto, TX 75115-2052
Phone (972) 296-5557

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
I20071203000445 TX Practitioner - Physician Assistant 7416046172 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA05360TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians and Allied Health Professionals Group, PA Past Accepting new patients
Dcoa Physicians PA Past Accepting new patients

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": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573430400000",
    "number": "1467647669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 YORK DR STE 102",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152052",
            "telephone_number": "972-296-5557",
            "fax_number": "972-296-5592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 YORK DR STE 102",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152052",
            "telephone_number": "972-296-5557",
            "fax_number": "972-296-5592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESPINOZA",
        "first_name": "LILIANA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-11",
        "last_updated": "2019-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA05360",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

Verify at the official NPI Registry.