Individual provider Active NPI

Hannah Grace Endres, PA-C

  • Medical Physician Assistant
  • Southlake, TX
National Provider Identifier
1487550661
Registry record updated Oct 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA20745 Issued in TX
Practice address
2813 W Southlake Blvd Ste 100
Southlake, TX 76092-6832
Phone
(682) 345-8010
NPI assigned
Oct 15, 2026
Last updated
Oct 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA20745 TX Primary

Addresses

Primary practice location

2813 W Southlake Blvd Ste 100
Southlake, TX 76092-6832

Mailing address

5541 Smokethorn Dr
Fort Worth, TX 76244-7518
Phone (817) 404-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1792022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792022400000",
    "number": "1487550661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5541 SMOKETHORN DR",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "762447518",
            "telephone_number": "817-404-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2813 W SOUTHLAKE BLVD STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760926832",
            "telephone_number": "682-345-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDRES",
        "first_name": "HANNAH",
        "middle_name": "GRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-15",
        "last_updated": "2026-10-15",
        "certification_date": "2026-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA20745",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.