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LIFESTREAM HEALTH CENTER PA
NPI 1235363409
Specialist in Coppell, TX

Active since May 04, 2009CLIA 45D2243851 · Waiver
705 MAIN ST, COPPELL, TX 75019(972) 304-6400(972) 304-6455 Get Directions Write a Review

NPPES record last updated: March 29, 2016. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Lifestream Health Center Pa NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LIFESTREAM HEALTH CENTER PA (NPI 1235363409) is a healthcare organization registered as a specialist in Coppell, Texas and active in the NPI registry since May 2009. The organization holds a CLIA Waiver certificate valid through November 22, 2027 and lists Brandon C Charles, President, as its authorized official.

NPPES Registry Identity

NPI1235363409
Entity TypeOrganization
Primary Taxonomy174400000X
Legal Business NameLIFESTREAM HEALTH CENTER PA
Location Address705 MAIN STCoppell, TX 75019-4742
Mailing Address705 Main StreetCoppell, TX 75019 · (972) 304-6400 · Fax (972) 304-6455
Phone(972) 304-6400
Fax(972) 304-6455
Organization SubpartYesParent: Lifesream Health Center Pa
Authorized OfficialBrandon C CharlesPresident · (972) 304-6400
Enumeration DateMay 4, 2009
Last NPPES UpdateMarch 29, 2016
✔ NPI 1235363409 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
License✔ Licensed in TX · H6110
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
705 MAIN ST, Coppell, TX 75019
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Other Identifiers 2

OtherH6110TX · Texas Medical Board License
Medicare UPINE28262TX

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections and more.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 45D2243851

Lifestream Health Centre & Med Spa · Coppell, TX
Active · expires Nov 22, 2027
CLIA Number45D2243851
Laboratory TypePhysician Office
Certificate Effective DateNovember 23, 2025
Certificate Expiration DateNovember 22, 2027
Laboratory DirectorBrandon Charles
Laboratory Phone(972) 304-6400
Laboratory LocationLifestream Health Centre & Med Spa705 Main St, Coppell, TX 75019
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HARRIS 4 HEALTH, PLLC
Nurse Practitioner (Family)
705 MAIN ST
COPPELL, TX 75019
Dallas County (972) 304-6400
DR. SHAROLYN K. DIHIGO DNP, RN, CPNP, FNP-C
Nurse Practitioner (Family)
705 MAIN ST
COPPELL, TX 75019
Dallas County (972) 304-6400
JANA ELISABETH ROGERS FNP-C
Nurse Practitioner (Family)
705 MAIN ST
COPPELL, TX 75019
Dallas County (972) 440-2359
MICHAEL D SULLIVAN PA
Physician Assistant
705 MAIN ST
COPPELL, TX 75019
Dallas County (972) 304-6400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lifestream Health Center PA's NPI number?

The NPI number for Lifestream Health Center PA is 1235363409. It was assigned to this organization in the NPPES registry on May 4, 2009.

Where is Lifestream Health Center PA located?

Lifestream Health Center PA is located at 705 Main St, Coppell, TX 75019. The listed phone number is (972) 304-6400.

What is Lifestream Health Center PA's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Does Lifestream Health Center PA hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 45D2243851) is associated with this NPI, valid through November 22, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Lifestream Health Center PA accept?

Health plans from Ambetter from Arizona Complete Health, Ambetter from Arkansas Health & Wellness, Ambetter from Louisiana Healthcare Connections, Ambetter from Superior HealthPlan and Ambetter of Oklahoma list Lifestream Health Center PA as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lifestream Health Center PA was last updated on March 29, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.