LAKIESHA BOHANNON (NPI# 1255889853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255889853 |
| Entity Type | Individual |
| Full Name | LAKIESHA BOHANNON |
| Credential | PA |
| Practice Address |
3600 Shire Blvd Ste 104 Richardson TX 75082-2236 |
| Practice Telephone | 9724876400 |
| Mailing Telephone | 9724876400 |
| Enumeration Date | 2016-09-13 |
| Last Update Date | 2020-08-04 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
PA13729 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3600 SHIRE BLVD STE 104 |
| City | RICHARDSON |
| State | TX |
| Zip Code | 75082-2236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558312504 | Walter Stuart Johnston | Surgery | 3600 Shire Blvd Ste 104, Richardson, TX 75082-2236 | 2006-05-15 |
| 1629395967 | Thomas Tien-yau Wang | Surgery | 3600 Shire Blvd Ste 104, Richardson, TX 75082-2236 | 2010-04-27 |
| 1912935560 | North Dallas Surgical Specialists, Pa | Surgery | 3600 Shire Blvd Ste 104, Richardson, TX 75082-2236 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124505367 | Texas Center for Hip & Knee Replacement Surgery, Pllc | Orthopaedic Surgery | Texas Center for Hip & Knee Replacement Surgery, Pllc, 2821 E. President George Bush Hwy, Suite 300, Richardson, TX 75082 | 2018-07-20 |
| 1033600481 | Hospital Specialist 4 Kids Pllc | Pediatrics | 1250 Hunt St Apt 1512, Richardson, TX 75082 | 2018-05-22 |
| 1174021760 | Kevin V Hua | Dentist | 4251 E. Renner Rd-, #126, Richardson, TX 75082 | 2018-01-29 |
| 1912410739 | Ntx Anesthesiology Consultants Pllc | Anesthesiology | 2100 Lakeside Blvd Ste 250, Richardson, TX 75082 | 2017-11-15 |
| 1982123931 | Jessica A Baxter | Occupational Therapist | 2150 Lakeside Blvd #150, Richardson, TX 75082 | 2017-09-11 |
| 1720509763 | Neylu Inc | Durable Medical Equipment & Medical Supplies | 45 Dunrobin, Richardson, TX 75082 | 2017-06-29 |
| 1578006342 | Janice Sun Couch | Registered Nurse | 3201 E Pres. Georgebush Hwy St. 101, Richardson, TX 75082 | 2016-11-29 |
| 1134678873 | Fresenius Medical Care Renner Road, LLC | Clinic/Center | 3317 Essex Dr Ste 150, Richardson, TX 75082 | 2016-09-22 |
| 1639529308 | James G Gray | Counselor | 101 W Renner Rd Ste 220, Richardson, TX 75082 | 2016-06-14 |
| 1245695907 | Richardson Smiles Pllc | Dentist | 2000 N Plano Rd #106, Richardson, TX 75082 | 2015-12-23 |
| Find all providers in zip 75082 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700250859 | Spine Surgical Services, Pllc | Physician Assistant | 908 Audelia Rd Ste 200-308, Richardson, TX 75081-5166 | 2015-11-30 |
| 1285018929 | Bk Assist, Pllc | Physician Assistant | 101 S Coit Rd Ste 36-267, Richardson, TX 75080-5743 | 2015-07-13 |
| 1346631165 | Northassist, LLC | Physician Assistant | 1202 E Arapaho Rd, Suite 122, Richardson, TX 75081-2477 | 2015-02-16 |
| 1578991022 | Tex Assist, LLC | Physician Assistant | 1105 Eastview Cir, Richardson, TX 75081-5431 | 2013-10-20 |
| 1174879159 | Breck James Wheelock | Physician Assistant | 1202 E Arapaho Rd Ste 122, Richardson, TX 75081-2400 | 2012-07-27 |
| 1659464691 | Donna Lynn Bailey | Physician Assistant | 204 Bridge Canyon Ct, Richardson, TX 75080-2600 | 2006-10-02 |
| 1699376459 | Oakmont Surgical Affiliates | Physician Assistant | 1202 E Arapaho Rd Ste 122, Richardson, TX 75081-2400 | 2020-11-06 |
| 1073114443 | Texassist Surgical Assist Staffing | Physician Assistant | 1202 E Arapaho Rd Ste 122, Richardson, TX 75081-2400 | 2020-11-03 |
| 1053927111 | Patient Plus | Physician Assistant | 1202 E Arapaho Rd Ste 122, Richardson, TX 75081-2400 | 2020-09-23 |
| 1447860531 | Complete Surgical Care LLC | Physician Assistant | 204 Bridge Canyon Ct, Richardson, TX 75080-2600 | 2020-08-04 |
| Find all providers in RICHARDSON | ||||
| City | RICHARDSON |
| Zip Code | 75082 |
Please comment or provide details below to improve the information on LAKIESHA BOHANNON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.