Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lakiesha Bohannon, PA

Individual provider Surgical Physician Assistant · NPI 1255889853

Lakiesha Bohannon, PA is a Physician Assistant in Richardson, Texas. Qualified in 2020, 6 years ago. Practices with Texas Trauma Medical Group, PLLC, a 52-clinician group and accepts Medicare assignment. Licensed in Texas.

Years since qualifying
6
Licensed in
TX
In the registry since
2016
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3600 Shire Blvd Ste 104
Richardson, TX 75082-2236
Phone: (972) 487-6400
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA13729 (TX)

Record details

NPI number1255889853
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedSeptember 13, 2016
Last updated in NPPESAugust 4, 2020
Certification dateAugust 4, 2020

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Texas Trauma Medical Group, Pllc — 52 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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