1. Home
  2. Directory
  3. Texas
  4. Flower Mound
  5. Physician Assistant
  6. NPI Profile

SOUKSAVANH LISA PHANTHAVONG PA-C
NPI 1619222874
Physician Assistant in Flower Mound, TX

Active since July 13, 2012PECOS EnrolledAccepts Medicare Assignment
4001 LONG PRAIRIE RD STE 125, FLOWER MOUND, TX 75028(972) 539-3030(972) 539-3037 Get Directions Write a Review

NPPES record last updated: August 12, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Aug 12, 2025, Jan 11, 2017, Oct 13, 2016 and 1 more (4 updates tracked since 2016).

About Souksavanh Lisa Phanthavong Pa-c NPPES

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

SOUKSAVANH LISA PHANTHAVONG PA-C (NPI 1619222874) is an individual physician assistant in Flower Mound, Texas, licensed in Texas (PA07876) and active in the NPI registry since July 2012. She is enrolled in Medicare PECOS and is a graduate of Other (2012).

NPPES Registry Identity

NPI1619222874
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameSOUKSAVANH LISA PHANTHAVONGCredential: PA-C
Location Address4001 LONG PRAIRIE RD STE 125Flower Mound, TX 75028-1532
Mailing Address4001 Long Prairie Rd Ste 125Flower Mound, TX 75028-1532 · (972) 539-3030 · Fax (972) 539-3037
Phone(972) 539-3030
Fax(972) 539-3037
Sole ProprietorNo
Medical School CMSOtherGraduated 2012
Enumeration DateJuly 13, 2012
Last NPPES UpdateAugust 12, 20254 updates tracked since enumeration
NPPES CertifiedAugust 12, 2025
✔ NPI 1619222874 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in TX · PA07876
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
4001 LONG PRAIRIE RD STE 125, Flower Mound, TX 75028
Open in Google Maps ↗

Other Names 1

Former Name (1)Souksavanh Lisa Bush Pa-c

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 ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Souksavanh Lisa Phanthavong Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6204060700
PECOS Enrollment IDI20150209001560
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75028 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.92 typical visit price
range $54.84 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.55 typical visit price
range $17.52 – $136.11
Typical copayment $17.13 (range $4.38 – $34.02)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

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

SCOTT MARTZ PA-C
Physician Assistant
4001 LONG PRAIRIE RD STE 125
FLOWER MOUND, TX 75028
Denton County (972) 539-3030
JACK M WRIGHT MD
Family Medicine
4001 LONG PRAIRIE RD STE 125
FLOWER MOUND, TX 75028
Denton County (972) 539-3030

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 Souksavanh Phanthavong's NPI number?

The NPI number for Souksavanh Phanthavong is 1619222874. It was assigned to this individual provider in the NPPES registry on July 13, 2012. The provider is also known as Souksavanh Lisa Bush Pa-C.

Where is Souksavanh Phanthavong located?

Souksavanh Phanthavong practices at 4001 Long Prairie Rd Ste 125, Flower Mound, TX 75028. The listed phone number is (972) 539-3030.

What is Souksavanh Phanthavong's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Souksavanh Phanthavong enrolled in Medicare?

Yes. Souksavanh Phanthavong is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Souksavanh Phanthavong 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 and 3 other insurers list Souksavanh Phanthavong 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 Souksavanh Phanthavong was last updated on August 12, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.