Individual provider Active NPI

Lilian William Paulla

  • Psychiatric/Mental Health Nurse Practitioner
  • Fairview, TX
National Provider Identifier
1780396382
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
1099807 Issued in TX
Practice address
5558 Emerson CT
Fairview, TX 75069-6809
Phone
(972) 900-1745
NPI assigned
Dec 15, 2022
Last updated
Dec 15, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 1099807 TX Primary

Addresses

Primary practice location

5558 Emerson CT
Fairview, TX 75069-6809

Mailing address

5558 Emerson CT
Fairview, TX 75069-6809
Phone (972) 900-1745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20240205002368 WA Practitioner - Nurse Practitioner 6305289505 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lourdes Hospital LLCGroup PAC ID 1850642562, 42 clinicians

Practice addresses (Care Compare)

1175 Carondelet Dr
Richland, WA 99354-3300
Phone (509) 943-9104

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1099807TXMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Senaya Primary Psychiatry PLLC Psychiatric/Mental Health CurrentSince Jul 23, 2023 Accepting new patients
Oasis Behavioral Home Health LLC Psychiatric/Mental Health CurrentSince Sep 1, 2024 Accepting new patients
Lourdes Hospital LLC CurrentSince Feb 26, 2024 Accepting new patients

Locations

8656 W Gage Blvd
Ste A106
Kennewick, WA 99336
Phone (509) 366-2108

1200 N 14th Ave
Pasco, WA 99301
Phone (509) 547-7536

7425 Wrigley Dr
Ste 204
Pasco, WA 99301
Phone (509) 416-0027

1175 Carondelet Dr
Richland, WA 99354
Phone (509) 240-5054

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1671062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1780396382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5558 EMERSON CT",
            "city": "FAIRVIEW",
            "state": "TX",
            "postal_code": "750696809",
            "telephone_number": "972-900-1745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5558 EMERSON CT",
            "city": "FAIRVIEW",
            "state": "TX",
            "postal_code": "750696809",
            "telephone_number": "972-900-1745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAULLA",
        "first_name": "LILIAN",
        "middle_name": "WILLIAM",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-15",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "1099807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairview, TX

Sources for this page

Verify at the official NPI Registry.