Lisa Denise Pallasch

Primary specialty

Licensed Vocational NurseTaxonomy code 164X00000X

License

112066 Issued in TX

Practice address

1255 W 15TH St Ste 1025
Plano, TX 75075-7253

Phone

(972) 673-0404

Fax

(972) 673-0420

NPI assigned

Aug 10, 2018

Last updated

Aug 10, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1533859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533859200000",
    "number": "1598244493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 W 15TH ST STE 1025",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757253",
            "telephone_number": "972-673-0404",
            "fax_number": "972-673-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 W 15TH ST STE 1025",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750757253",
            "telephone_number": "972-673-0404",
            "fax_number": "972-673-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALLASCH",
        "first_name": "LISA",
        "middle_name": "DENISE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-10",
        "last_updated": "2018-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164X00000X",
            "taxonomy_group": "",
            "desc": "Licensed Vocational Nurse",
            "state": "TX",
            "license": "112066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "112066",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Licensed Vocational Nurse in Plano, TX
• Providers in Plano, TX by specialty
• Licensed Vocational Nurse in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2018; 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.