Individual provider Active NPI

Laura Catalina De Moya Vega, M.D.

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1497863187
Registry record updated May 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M4028 Issued in TX
Practice address
3500 Gaston Ave
4 Roberts
Dallas, TX 75246-2017
Phone
(214) 820-3000
Fax
(214) 820-3022
NPI assigned
Aug 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X M4028 TX
Internal Medicine Physician 207R00000X M4028 TX Primary

Addresses

Primary practice location

3500 Gaston Ave
4 Roberts
Dallas, TX 75246-2017

Mailing address

3500 Gaston Ave
4 Roberts
Dallas, TX 75246-2017
Phone (214) 820-3000

Other identifiers 5

IdentifierTypeStateIssuer
183953202MedicaidTX
183953201MedicaidTX
8G0894OtherTXBCBS
8CZ844OtherTXBCBSTX
183953203MedicaidTX

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ldemoya225189@direct.sw.org

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070129000288 TX Practitioner - Internal Medicine 4385645795 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
M4028TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
Inpatient Physician Associates PLLC Internal Medicine CurrentSince Jun 1, 2018 Accepting new patients
Healthtexas Provider Network--Dallas Diagnostic Association Internal Medicine CurrentSince Dec 1, 2017 Accepting new patients
Healthtexas Provider Network CurrentSince Nov 1, 2018 Accepting new patients
Healthtexas Provider Network CurrentSince Nov 1, 2018 Accepting new patients
Healthtexas-Dallas Diagnostic Association Internal Medicine CurrentSince Dec 1, 2017 Accepting new patients

Locations

3500 Gaston Ave
#4
Dallas, TX 75246
Phone (214) 820-1000

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

6901 Snider Plz
Ste 130
Dallas, TX 75205
Phone (972) 381-6690

3409 Worth St
Ste 410
Dallas, TX 75246
Phone (214) 820-6544

3434 Swiss Ave
Ste 201
Dallas, TX 75204
Phone (214) 828-5000

3600 Gaston Ave
Ste 558
Dallas, TX 75246

700 Walter Reed Blvd
Ste 203
Garland, TX 75042
Phone (972) 426-9900

1441 S Midlothian Pkwy
Ste 100A
Midlothian, TX 76065
Phone (469) 800-9440

4700 Alliance Blvd
Ste 400
Plano, TX 75093
Phone (469) 814-6631

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

2400 N Interstate Highway 35 E
Waxahachie, TX 75165
Phone (469) 843-4000

Organizations & group practices 6

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": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682985600000",
    "number": "1497863187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVE",
            "address_2": "4 ROBERTS",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462017",
            "telephone_number": "214-820-3000",
            "fax_number": "214-820-3022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVE",
            "address_2": "4 ROBERTS",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462017",
            "telephone_number": "214-820-3000",
            "fax_number": "214-820-3022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE MOYA VEGA",
        "first_name": "LAURA",
        "middle_name": "CATALINA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2023-05-02",
        "certification_date": "2023-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "M4028",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M4028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183953202",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183953201",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8G0894",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSTX",
            "identifier": "8CZ844",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "183953203",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ldemoya225189@direct.sw.org",
            "affiliation": "N",
            "address_1": "2400 N I 35",
            "city": "Waxahachie",
            "state": "TX",
            "country_code": "US",
            "postal_code": "751655240",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.