Lu Liu First Assist PLLC

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA02204 Issued in TX

Legal business name

LU LIU FIRST ASSIST PLLC

Practice address

615 Teresa LN
Grand Prairie, TX 75052-2816

Phone

(972) 264-8575

Fax

(972) 264-8575

NPI assigned

Sep 25, 2009

Organization subpart

No

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

Authorized official

Name

Lu Liu, PHYSICIAN ASSISTANT

Title

Surgical PA-C

Phone

(972) 264-8575

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1253836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253836800000",
    "number": "1598099319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 TERESA LN",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750522816",
            "telephone_number": "972-264-8575",
            "fax_number": "972-264-8575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 TERESA LN",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750522816",
            "telephone_number": "972-264-8575",
            "fax_number": "972-264-8575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LU LIU FIRST ASSIST PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-25",
        "last_updated": "2009-09-25",
        "status": "A",
        "authorized_official_last_name": "LIU",
        "authorized_official_first_name": "LU",
        "authorized_official_title_or_position": "SURGICAL PA-C",
        "authorized_official_telephone_number": "972-264-8575",
        "authorized_official_credential": "PHYSICIAN ASSISTANT"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Surgical",
            "state": "TX",
            "license": "PA02204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICAID NUMBER",
            "identifier": "187944701",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICARE PIN NUMBER",
            "identifier": "82N820",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL MEDICARE UPIN NUMBER",
            "identifier": "S60053",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI NUMBER",
            "identifier": "1093776635",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgical Physician Assistant in Grand Prairie, TX
• Providers in Grand Prairie, TX by specialty
• Surgical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.