NPIMap

Organization Active NPI

Lisbon Tech LLC

  • Surgery of the Hand (Surgery) Physician
  • Dallas, TX
National Provider Identifier
1780110684
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery of the Hand (Surgery) PhysicianTaxonomy code 2086S0105X
Legal business name
LISBON TECH LLC
Practice address
9 Medical Pkwy Ste 101
Dallas, TX 75234-7852
Phone
(972) 919-4747
Fax
(972) 919-4749
NPI assigned
May 11, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Authorized official

Name
Dustin RayNPI 1639351216
Title
Owner
Phone
(888) 544-3339

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0600X
Surgery of the Hand (Surgery) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0105X Primary

Addresses

Primary practice location

9 Medical Pkwy Ste 101
Dallas, TX 75234-7852

Mailing address

9 Medical Pkwy Ste 101
Dallas, TX 75234-7852
Phone (888) 544-3339

Other names 1

  • The Hand Surgery Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200805002957 TX Part B Supplier - Clinic/Group Practice 4183049315 Receives reassigned benefits from 4 practitioners
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Locations

9 Medical Pkwy
Ste 101
Dallas, TX 75234
Phone (972) 919-4747

Practitioners & affiliated clinicians

Practitioners 4

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": "1494460800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659657600000",
    "number": "1780110684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 MEDICAL PKWY STE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347852",
            "telephone_number": "888-544-3339",
            "fax_number": "214-853-5728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 MEDICAL PKWY STE 101",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752347852",
            "telephone_number": "972-919-4747",
            "fax_number": "972-919-4749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISBON TECH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-11",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "RAY",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "888-544-3339"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Surgery of the Hand",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Hand Surgery Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Hand Surgery Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Aug 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.