Individual provider Active NPI

Lauren Elizabeth Thomas, PNP

  • Pediatric Nurse Practitioner
  • Bryan, TX
National Provider Identifier
1780379107
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
1114972 Issued in TX
Practice address
1301 Memorial Dr
Bryan, TX 77802-5205
Phone
(979) 693-7400
NPI assigned
Apr 11, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 1114972 TX Primary

Addresses

Primary practice location

1301 Memorial Dr
Bryan, TX 77802-5205

Mailing address

1500 University Dr E Ste 100
College Station, TX 77840-2600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240229001986 TX Practitioner - Nurse Practitioner 2264877257 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1114972TXMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Feb 5, 2024 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. CurrentSince Feb 5, 2024 Accepting new patients
Barrio Comprehensive Family Health Care Center, Inc. Current Accepting new patients

Locations

1102 Barclay St
San Antonio, TX 78207
Phone (210) 434-0513

20306 Encino Ledge
Ste 101
San Antonio, TX 78259
Phone (210) 233-7063

14625 Huebner Rd
San Antonio, TX 78230

3066 E Commerce St
San Antonio, TX 78220
Phone (210) 233-7062

Organizations & group practices 3

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": "1681171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1780379107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 UNIVERSITY DR E STE 100",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778402600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 MEMORIAL DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778025205",
            "telephone_number": "979-693-7400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "LAUREN",
        "middle_name": "ELIZABETH",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-11",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "TX",
            "license": "1114972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

Verify at the official NPI Registry.