Individual provider Active NPI

Lynne Wurts, MD

  • Dermatology Physician
  • Dallas, TX
National Provider Identifier
1629035282
Registry record updated Apr 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
F4068 Issued in TX
Practice address
10611 Garland Rd Ste 210
Dallas, TX 75218-2695
Phone
(214) 324-2881
Fax
(214) 328-4084
NPI assigned
Apr 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X F4068 TX Primary

Addresses

Primary practice location

10611 Garland Rd Ste 210
Dallas, TX 75218-2695

Mailing address

10611 Garland Rd Ste 210
Dallas, TX 75218-2695
Phone (214) 324-2881

Other identifiers 1

IdentifierTypeStateIssuer
141168801MedicaidTX

Medicare participation

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

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group Dermatology Past Accepting new patients
Elizabeth T Dolan, MD PA Dermatology PastSince Jan 1, 2007 Accepting new patients

Organizations & group practices 2

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": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333929600000",
    "number": "1629035282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10611 GARLAND RD STE 210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752182695",
            "telephone_number": "214-324-2881",
            "fax_number": "214-328-4084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10611 GARLAND RD STE 210",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752182695",
            "telephone_number": "214-324-2881",
            "fax_number": "214-328-4084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WURTS",
        "first_name": "LYNNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-27",
        "last_updated": "2012-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "TX",
            "license": "F4068",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "141168801",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; 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.