Lifegenix Med PLLC

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

Legal business name

LIFEGENIX MED PLLC

Practice address

17230 Dallas Pkwy Ste 110
Dallas, TX 75248-1136

Phone

(972) 236-3333

Fax

(972) 920-3754

NPI assigned

Mar 10, 2025

Organization subpart

No

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

Authorized official

Name

Laurie Clemons

Title

VP of Operations

Phone

(972) 236-3333

Specialties & licenses 2

Addresses

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

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

{
    "created_epoch": "1741564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1689473068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17230 DALLAS PKWY STE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481136",
            "telephone_number": "972-236-3333",
            "fax_number": "972-920-3754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17230 DALLAS PKWY STE 110",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752481136",
            "telephone_number": "972-236-3333",
            "fax_number": "972-920-3754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEGENIX MED PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-10",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "CLEMONS",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "972-236-3333"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sports Medicine (Orthopaedic Surgery) Physician in Dallas, TX
• Providers in Dallas, TX by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.