Individual provider Active NPI

Lisa Schydlower Sullivan, M.D.

  • Pediatrics Physician
  • Temple, TX
National Provider Identifier
1922254309
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
M9682 Issued in TX
Practice address
6684 W Adams Ave
Temple, TX 76502-5632
Phone
(254) 899-4200
Fax
(254) 899-4205
NPI assigned
Aug 17, 2008
Last updated
Jul 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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 M9682 TX Primary

Addresses

Primary practice location

6684 W Adams Ave
Temple, TX 76502-5632

Mailing address

PO Box 844658
Dallas, TX 75284-4658
Phone (254) 724-2111

Other practice location 1

3801 Scott and White Dr
Killeen, TX 76543-5252
Phone (254) 680-1100

Other names 1

  • Ms. Lisa Schydlower Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address lsullivan11446@direct.sw.org Direct

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
I20090327000077 TX Practitioner - Pediatric Medicine 2961569413 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
M9682TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Scott & White Hospital - Taylor Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lsullivan11446@direct.sw.org

Organizations & group practices 2

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": "1218931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1922254309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 844658",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752844658",
            "telephone_number": "254-724-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6684 W ADAMS AVE",
            "city": "TEMPLE",
            "state": "TX",
            "postal_code": "765025632",
            "telephone_number": "254-899-4200",
            "fax_number": "254-899-4205"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3801 Scott and White Dr",
            "address_purpose": "LOCATION",
            "city": "Killeen",
            "state": "TX",
            "postal_code": "765435252",
            "country_code": "US",
            "telephone_number": "254-680-1100",
            "fax_number": "254-699-3835",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LISA",
        "middle_name": "SCHYDLOWER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-17",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "M9682",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lsullivan11446@direct.sw.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3801 Scott and White Dr",
            "city": "Killeen",
            "state": "TX",
            "country_code": "US",
            "postal_code": "765435252",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "SCHYDLOWER",
            "prefix": "MS.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Temple, TX

Sources for this page

Verify at the official NPI Registry.