TAMMY L. PON (NPI# 1972589596) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972589596 |
| Entity Type | Individual |
| Full Name | TAMMY L. PON |
| Credential | MD |
| Practice Address |
3310 Live Oak St Copc Administration Dallas TX 75204-6153 |
| Mailing Address |
Po Box 660599 Dallas TX 75266-0599 |
| Practice Telephone | 2142661247 |
| Practice Fax Number | 2142661246 |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2009-09-04 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | J0206 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | RAILROAD MEDICARE | 080182188 | 01 |
| TX | 102496003 | 05 | |
| TX | 102496007 | 05 | |
| TX | 102496021 | 05 | |
| TX | 102496019 | 05 | |
| TX | 102496004 | 05 | |
| TX | 102496013 | 05 | |
| TX | 102496017 | 05 | |
| TX | 102496005 | 05 | |
| TX | 102496006 | 05 | |
| TX | 102496016 | 05 | |
| TX | 102496018 | 05 | |
| TX | 102496020 | 05 | |
| TX | 102496010 | 05 | |
| TX | 102496002 | 05 | |
| TX | 102496014 | 05 | |
| TX | BLUE CROSS BLUE SHIELD | 81Y187 | 01 |
| Street Address |
3310 LIVE OAK ST COPC ADMINISTRATION |
| City | DALLAS |
| State | TX |
| Zip Code | 75204-6153 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306842216 | Khalida Yasmin | Family Medicine | 3310 Live Oak St, Dallas, TX 75204-6153 | 2005-06-24 |
| 1295151884 | Laura Fortner | Doula | 3310 Live Oak St, Suite 201, Dallas, TX 75204-6153 | 2014-03-07 |
| 1396049698 | Amerismiles Inc | Dentist | 3310 Live Oak St, Suite 200, Dallas, TX 75204-6153 | 2010-12-29 |
| 1346413317 | April Nicole Campbell | Physician Assistant | 3310 Live Oak St, Youth & Family Centers, Dallas, TX 75204-6153 | 2008-04-10 |
| 1518155258 | Audrey L. Graham, Md, Pa | Specialist | 3310 Live Oak St, 400, Dallas, TX 75204-6147 | 2007-10-09 |
| 1013102839 | Druthil Belur | Dentist | 3310 Live Oak St, #200, Dallas, TX 75204-6153 | 2007-09-14 |
| 1841485638 | Deepa Narayanan | Family Medicine | 3310 Live Oak St, Dallas, TX 75204-6153 | 2007-09-13 |
| 1053511915 | Jenaya Judonne Ward | Obstetrics & Gynecology | 3310 Live Oak St, Suite 210, Dallas, TX 75204-6153 | 2007-07-19 |
| 1447301379 | Pgvpediatrics, Pa | Pediatrics | 3310 Live Oak St, Suite 201, Dallas, TX 75204-6153 | 2007-01-16 |
| 1972688224 | Aaron Van Wright | Psychiatry & Neurology | 3310 Live Oak St, Dallas, TX 75204-6153 | 2006-10-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164020350 | Christina Wilder | Nurse Practitioner | 821 Allen Street Apt 424, Dallas, TX 75204 | 2020-10-11 |
| 1710441803 | Axownal Monitoring, Pllc | Electrodiagnostic Medicine | 2633 Mckinney Ave Ste 130 #329, Dallas, TX 75204 | 2019-01-23 |
| 1275026221 | Taylor Houser | Advanced Practice Midwife | 3611 Swiss Ave Ste 200, Dallas, TX 75204 | 2018-06-13 |
| 1407372147 | Regan Paulsen | Counselor | 4144 N. Central Expressway 955, 955, Dallas, TX 75204 | 2017-08-15 |
| 1639621311 | Pat Thi Nguyen | Nurse Practitioner | 3133 Lemmon Ave East, Dallas, TX 75204 | 2016-10-28 |
| 1770957896 | Dendrite Monitoring Services, Pllc | Electrodiagnostic Medicine | 2633 Mckinney Ave, Ste 130 # 335, Dallas, TX 75204 | 2015-12-01 |
| 1245609858 | Heather Eileen Li | Pharmacist | 2830 State St, Dallas, TX 75204 | 2015-09-24 |
| 1437527223 | Christy Walker | Nurse Practitioner | 2420 Clark St #703, Dallas, TX 75204 | 2015-09-10 |
| 1740678077 | Margaret Dutton | Physical Therapist | 4200 Live Oak, Dallas, TX 75204 | 2015-01-09 |
| 1639579659 | Cvs Pharmacy Inc | Durable Medical Equipment & Medical Supplies | 3133 Lemmon Ave E, Dallas, TX 75204 | 2014-08-27 |
| Find all providers in zip 75204 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245853811 | Forest Family Clinic, LLC | Family Medicine | 9550 Forest Ln Suite 606, Dallas, TX 75243-5905 | 2020-05-18 |
| 1104447937 | Centenary Family & Urgent Care | Family Medicine | 8702 S Lancaster Rd Ste 160a, Dallas, TX 75241-6301 | 2020-05-04 |
| 1285274456 | Genesis Health Partners Pllc | Family Medicine | 8390 Lbj Fwy Ste 1000b, Dallas, TX 75243-1188 | 2020-01-15 |
| 1194368266 | Sierra Healthcare Network LLC | Family Medicine | 2727 Lbj Fwy Ste 326, Dallas, TX 75234-7478 | 2019-10-22 |
| 1184274896 | Matilda N Nju | Family Medicine | 41 Kelso Way, Dallas, GA 30132-2618 | 2019-09-14 |
| 1992366488 | Anmd Health Pllc | Family Medicine | 1910 Pacific Ave Suite 15700, Dallas, TX 75201 | 2019-06-25 |
| 1366908600 | Advanced Wound Care of North Texas Pllc | Family Medicine | 13154 Coit Rd Ste 102d, Dallas, TX 75240-5787 | 2019-02-12 |
| 1932664935 | Environmental Health Center - North Texas Pa | Family Medicine | 8345 Walnut Hill Ln Ste 220, Dallas, TX 75231-4205 | 2019-02-04 |
| 1679043723 | Inwood Medical Clinic Inc. | Family Medicine | 2916 Inwood Rd, Dallas, TX 75235-7518 | 2018-12-03 |
| 1134698939 | Cayla Schaner | Family Medicine | 3600 Gaston Ave Ste 1109, Dallas, TX 75246-1811 | 2018-11-21 |
| Find all providers in DALLAS | ||||
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| 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.