Active NPI
Kathleen Eva Wahl, PA-C
- Physician Assistant
- Dallas, TX
National Provider Identifier
1154190817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA18667
- Practice address
- 1935 Medical District Dr
Dallas, TX 75235-7701 - Phone
- (214) 456-7000
- NPI assigned
- Dec 21, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Physician Assistant | 363A00000X | PA18667 | TX | Primary |
Addresses
Primary practice location
1935 Medical District Dr
Dallas, TX 75235-7701
Mailing address
3717 Cole Ave Apt 300
Dallas, TX 75204-4532
Phone (615) 478-3555
Other practice location 1
825 Fairfax Ave
Norfolk, VA 23507-1912
Phone (757) 446-5600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5323 Harry Hines Blvd
Dallas, TX 75390-7208
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA18667 | TX | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1703116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1741651200000",
"number": "1154190817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3717 COLE AVE APT 300",
"city": "DALLAS",
"state": "TX",
"postal_code": "752044532",
"telephone_number": "615-478-3555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1935 MEDICAL DISTRICT DR",
"city": "DALLAS",
"state": "TX",
"postal_code": "752357701",
"telephone_number": "214-456-7000"
}
],
"practiceLocations": [
{
"address_1": "825 Fairfax Ave",
"address_purpose": "LOCATION",
"city": "Norfolk",
"state": "VA",
"postal_code": "235071912",
"country_code": "US",
"telephone_number": "757-446-5600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WAHL",
"first_name": "KATHLEEN",
"middle_name": "EVA",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-12-21",
"last_updated": "2025-03-11",
"certification_date": "2025-03-11",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "TX",
"license": "PA18667",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.