NPIMap

Organization Active NPI

Live Oak Emergency Physicians PLLC

  • Emergency Medicine Physician
  • Mesquite, TX
National Provider Identifier
1679040562
Registry record updated Apr 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
LIVE OAK EMERGENCY PHYSICIANS PLLC
Practice address
1011 N Galloway Ave
Mesquite, TX 75149-2433
Phone
(469) 401-2386
NPI assigned
Oct 29, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2021

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

Authorized official

Name
Kathleen Kondas
Title
Officer
Phone
(973) 251-1132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

1011 N Galloway Ave
Mesquite, TX 75149-2433

Mailing address

PO Box 99102
Las Vegas, NV 89193-9085

Other practice location 1

7 Medical Pkwy
Dallas, TX 75234-7829
Phone (469) 401-2386

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1540771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1679040562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99102",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891939085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N GALLOWAY AVE",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751492433",
            "telephone_number": "469-401-2386"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7 Medical Pkwy",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752347829",
            "country_code": "US",
            "telephone_number": "469-401-2386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIVE OAK EMERGENCY PHYSICIANS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-29",
        "last_updated": "2021-04-12",
        "certification_date": "2021-04-12",
        "status": "A",
        "authorized_official_last_name": "KONDAS",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_title_or_position": "OFFICER",
        "authorized_official_telephone_number": "973-251-1132"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesquite, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.