Individual provider Active NPI

Ann Liu, MD

  • Pediatrics Physician
  • Dallas, TX
National Provider Identifier
1912049545
Registry record updated Jun 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M3630 Issued in TX
Practice address
7777 Forest LN Ste B300
Dallas, TX 75230-2510
Phone
(972) 284-7770
Fax
(972) 284-7780
NPI assigned
Feb 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X M3630 TX Primary

Addresses

Primary practice location

7777 Forest LN Ste B300
Dallas, TX 75230-2510

Mailing address

P.O. Box 961205
Fort Worth, TX 76161-1205
Phone (817) 740-8450

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170622000531 TX Practitioner - Pediatric Medicine 3476530288 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Health Care, P.L.L.C. Current Accepting new patients
Texas Health Care, P.L.L.C. CurrentSince Aug 1, 2017 Accepting new patients
Texas Health Care, P.L.L.C. CurrentSince Aug 1, 2017 Accepting new patients
Columbia Hospital at Medical City Dallas Subsidiary LP Past Accepting new patients
Forest Lane Pediatrics Pediatrics PastSince Jun 21, 2020 Accepting new patients

Locations

3500 Gaston Ave
Dallas, TX 75246

7777 Forest Ln
Ste B300
Dallas, TX 75230
Phone (972) 284-7770

7777 Forest Ln
Ste B445
Dallas, TX 75230
Phone (972) 566-6900

2821 Lackland Rd
Ste 300
Ft Worth, TX 76116
Phone (817) 740-8400

6700 Buenos Aires Dr
North Richlnd Hls, TX 76180
Phone (817) 281-8245

920 Santa Fe Dr
Ste 103
Weatherford, TX 76086
Phone (817) 339-8855

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/9229/brand/1/csg/1/fhir/r4

Organizations & group practices 5

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": "1171238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592352000000",
    "number": "1912049545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 961205",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761611205",
            "telephone_number": "817-740-8450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 FOREST LN STE B300",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752302510",
            "telephone_number": "972-284-7770",
            "fax_number": "972-284-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-12",
        "last_updated": "2020-06-17",
        "certification_date": "2020-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M3630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.