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LAKE COUNTRY FAMILY MEDICINE, P.A.
NPI 1629392063
Family Medicine in Fort Worth, TX

Active since March 14, 2010
8465 BOAT CLUB RD STE 115, FORT WORTH, TX 76179(817) 260-0535(817) 984-1448 Get Directions Write a Review

NPPES record last updated: March 12, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

Record update history: Mar 12, 2026, Oct 3, 2023 (2 updates tracked since 2023).

About Lake Country Family Medicine, P.a. NPPES

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

LAKE COUNTRY FAMILY MEDICINE, P.A. (NPI 1629392063) is a healthcare organization registered as a family medicine in Fort Worth, Texas and active in the NPI registry since March 2010. The organization lists Yung Chen, Owner/physician, as its authorized official.

NPPES Registry Identity

NPI1629392063
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameLAKE COUNTRY FAMILY MEDICINE, P.A.
Location Address8465 BOAT CLUB RD STE 115Fort Worth, TX 76179-3676
Mailing Address8465 Boat Club Rd Ste 115Fort Worth, TX 76179-3676 · (817) 260-0535 · Fax (817) 984-1448
Phone(817) 260-0535
Fax(817) 984-1448
Organization SubpartNo
Authorized OfficialYung ChenOwner/physician · (817) 260-0535
Enumeration DateMarch 14, 2010
Last NPPES UpdateMarch 12, 20262 updates tracked since enumeration
NPPES CertifiedMarch 12, 2026
✔ NPI 1629392063 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
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.
8465 BOAT CLUB RD STE 115, Fort Worth, TX 76179
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Other Identifiers 1

Medicaid2144495TX

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 WellPoint.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 45D2014261

Lake Country Family Medicine, PA · Fort Worth, TX
Expired · Oct 4, 2026
CLIA Number45D2014261
Laboratory TypePhysician Office
Certificate Effective DateOctober 5, 2024
Certificate Expiration DateOctober 4, 2026
Laboratory DirectorYung S. Chen
Laboratory Phone(817) 260-0535
Laboratory LocationLake Country Family Medicine, PA8465 Boat Club Road, Suite 115, Fort Worth, TX 76179
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES

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

BIANCA ADRIANNA AGNELLO FNP-C
Nurse Practitioner (Family)
8465 BOAT CLUB RD STE 115
FORT WORTH, TX 76179
Tarrant County (817) 260-0535

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 Lake Country Family Medicine, P.A.'s NPI number?

The NPI number for Lake Country Family Medicine, P.A. is 1629392063. It was assigned to this organization in the NPPES registry on March 14, 2010.

Where is Lake Country Family Medicine, P.A. located?

Lake Country Family Medicine, P.A. is located at 8465 Boat Club Rd Ste 115, Fort Worth, TX 76179. The listed phone number is (817) 260-0535.

What is Lake Country Family Medicine, P.A.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

What insurance does Lake Country Family Medicine, P.A. accept?

Health plans from WellPoint list Lake Country Family Medicine, P.A. 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 Lake Country Family Medicine, P.A. was last updated on March 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.