ADDISON INTERNAL MEDICINE NPI 1043695695

NPI Information

  • NPI: 1043695695
  • Provider Name: ADDISON INTERNAL MEDICINE
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • CLIA Number: 45D2064984
  • Address: 17051 DALLAS PKWY STE 150
    ADDISON, TX
    ZIP 75001
  • Phone: (972) 733-3090

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NPI Details

ADDISON INTERNAL MEDICINE is a family nurse practitioner in Addison, TX. ADDISON INTERNAL MEDICINE NPI is 1043695695. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

17051 DALLAS PKWY STE 150
ADDISON, TX
ZIP 75001-106
Phone: (972) 733-3090
Fax: (972) 733-4565

The provider's authorized official is Tri Nguyen .
The authorized official title is Medical Director and has the following contact phone number (972) 733-3090.

The CLIA number assigned to this NPI record is 45D2064984 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/24/2015 and was last updated on 7/24/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyAP128604TEXASYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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