Organization Active NPI

Gurpreet S Dhaliwal MD P a

  • Neurology Physician
  • Burleson, TX
National Provider Identifier
1063766657
Registry record updated Nov 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
GURPREET S DHALIWAL MD P A
Practice address
11803 South Fwy
Suite 210
Burleson, TX 76028-7012
Phone
(817) 551-6000
NPI assigned
Nov 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Gurpreet Dhaliwal, MDNPI 1780601286
Title
President
Phone
(817) 551-6000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary

Addresses

Primary practice location

11803 South Fwy
Suite 210
Burleson, TX 76028-7012

Mailing address

11803 South Fwy
Suite 210
Burleson, TX 76028-7012
Phone (817) 551-6000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130418000514 TX Part B Supplier - Clinic/Group Practice 6709022650 Receives reassigned benefits from 1 practitioner
Practice locations: Burleson, TX

National Provider Directory

National Provider Directory

Locations

11797 South Fwy
Ste 350
Burleson, TX 76028
Phone (817) 551-1304

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1351987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351987200000",
    "number": "1063766657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11803 SOUTH FWY",
            "address_2": "SUITE 210",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287012",
            "telephone_number": "817-551-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11803 SOUTH FWY",
            "address_2": "SUITE 210",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287012",
            "telephone_number": "817-551-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GURPREET S DHALIWAL MD P A",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-04",
        "last_updated": "2012-11-04",
        "status": "A",
        "authorized_official_last_name": "DHALIWAL",
        "authorized_official_first_name": "GURPREET",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-551-6000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.