NPIMap

Individual provider Active NPI

Lisa Nguyen, D.O.

  • Family Medicine Physician
  • Wylie, TX
National Provider Identifier
1720348022
Registry record updated Jul 26, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q2692 Issued in TX
Practice address
600 Cooper Dr Ste 100
Wylie, TX 75098-3969
Phone
(972) 442-7325
NPI assigned
May 21, 2012
Last updated
Jul 26, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 26, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X Q2692 TX
Family Medicine Physician 207Q00000X Q2692 TX Primary

Addresses

Primary practice location

600 Cooper Dr Ste 100
Wylie, TX 75098-3969

Mailing address

637 Gray Stone LN
Richardson, TX 75081-3559
Phone (214) 755-6917

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lnguyen225966@direct.sw.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150612000520 TX Practitioner - Family PracticePractitioner - Emergency Medicine 3274844584 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

4001 Worth St
Dallas, TX 75246-1608

600 Cooper Dr
Wylie, TX 75098-3969

7217 Telecom Pkwy
Garland, TX 75044-2203

821 N Coleman St
Suite 100
Prosper, TX 75078-2339
Phone (469) 800-5200

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
Q2692TXMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network Family Medicine CurrentSince Oct 5, 2015 Accepting new patients
Healthtexas Provider Network CurrentSince Oct 5, 2015 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Southwest Medical Associates, Inc. Emergency Medicine CurrentSince May 27, 2015 Accepting new patients
CD Urgent Care Center 5, PLLC Past Accepting new patients
Paul Phillips III, M.D., P.a. Past Accepting new patients

Locations

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

1416 George Dieter Dr
El Paso, TX 79936
Phone (877) 822-6281

821 N Coleman St
Ste 100
Prosper, TX 75078
Phone (469) 800-5200

600 Cooper Dr
Ste 100
Wylie, TX 75098
Phone (972) 231-1591

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1337558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690329600000",
    "number": "1720348022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "637 GRAY STONE LN",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "750813559",
            "telephone_number": "214-755-6917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 COOPER DR STE 100",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750983969",
            "telephone_number": "972-442-7325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "LISA",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-21",
        "last_updated": "2023-07-26",
        "certification_date": "2023-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "Q2692",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q2692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lnguyen225966@direct.sw.org",
            "affiliation": "N",
            "address_1": "600 Cooper Dr Ste 100",
            "city": "Wylie",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750983969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Wylie, TX

Sources for this page

Verify at the official NPI Registry.