The Dallas Clinic 23 PLLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

THE DALLAS CLINIC 23 PLLC

Doing business as

Wheatland Internal Medicine Clinic

Practice address

2701 Prince George Ave Ste 100
Desoto, TX 75115-2087

Phone

(972) 634-8110

Fax

(972) 634-8220

NPI assigned

Feb 23, 2024

Last updated

Feb 23, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Shehetaj Abdurrahim, MDNPI 1437188372

Title

Managing Physician

Phone

(972) 634-8110

Specialties & licenses 1

Addresses

Other names 1

• Wheatland Internal Medicine Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Shehetaj G Abdurrahim, MD

  • Internal Medicine Physician
  • Desoto, TX
  • NPI 1437188372
  Medicare reassignment NPD Authorized official
• Noemi Rodriguez, FNP-C

  • Family Nurse Practitioner
  • Desoto, TX
  • NPI 1205655875
  Medicare reassignment NPD
• Angel Shibu, PA-C

  • Physician Assistant
  • Desoto, TX
  • NPI 1073494191
  Medicare reassignment NPD

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

{
    "created_epoch": "1708646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708646400000",
    "number": "1255197653",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2701 PRINCE GEORGE AVE STE 100",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152087",
            "telephone_number": "972-555-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 PRINCE GEORGE AVE STE 100",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152087",
            "telephone_number": "972-634-8110",
            "fax_number": "972-634-8220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DALLAS CLINIC 23 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-23",
        "last_updated": "2024-02-23",
        "certification_date": "2024-02-23",
        "status": "A",
        "authorized_official_last_name": "ABDURRAHIM",
        "authorized_official_first_name": "SHEHETAJ",
        "authorized_official_title_or_position": "MANAGING PHYSICIAN",
        "authorized_official_telephone_number": "972-634-8110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wheatland Internal Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Wheatland Internal Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Desoto, TX
• Providers in Desoto, TX by specialty
• Internal Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.