NPIMap

Organization Active NPI

Medical Leaders and Associates, PLLC

  • Internal Medicine Physician
  • West Columbia, TX
National Provider Identifier
1255567772
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDICAL LEADERS AND ASSOCIATES, PLLC
Practice address
513 S Columbia Dr
West Columbia, TX 77486-3025
Phone
(979) 345-6522
Fax
(979) 345-4922
NPI assigned
Jun 10, 2009
Last updated
May 20, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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

Authorized official

Name
M Atiq Dada, M.D.
Title
Owner
Phone
(979) 548-6783

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X

Addresses

Primary practice location

513 S Columbia Dr
West Columbia, TX 77486-3025

Mailing address

PO Box 2660
Bay City, TX 77404-2660
Phone (979) 245-2421

Other identifiers 1

IdentifierTypeStateIssuer
212014901MedicaidTX

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090713000469 TX Part B Supplier - Clinic/Group Practice 2365594983 Receives reassigned benefits from 16 practitioners
Practice locations: Wharton, TX; Bay City, TX; West Columbia, TX; Van Vleck, TX; Sweeny, TX; Sugar Land, TX; Lake Jackson, TX; Palacios, TX…

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2013732Medical Leaders and Assoc, PLLC513 S Columbia Dr, West Columbia, TX 77486Provider-performed microscopySep 22, 2026

National Provider Directory

National Provider Directory

Locations

146 E Hospital Dr
Ste 103
Angleton, TX 77515
Phone (979) 319-3001

16035 Lexington Blvd
Sugar Land, TX 77479
Phone (832) 532-7836

170 4th St S
Ste 2
Van Vleck, TX 77482
Phone (979) 429-2011

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1244592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1653004800000",
    "number": "1255567772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2660",
            "city": "BAY CITY",
            "state": "TX",
            "postal_code": "774042660",
            "telephone_number": "979-245-2421",
            "fax_number": "979-345-4922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "513 S COLUMBIA DR",
            "city": "WEST COLUMBIA",
            "state": "TX",
            "postal_code": "774863025",
            "telephone_number": "979-345-6522",
            "fax_number": "979-345-4922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL LEADERS AND ASSOCIATES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-10",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A",
        "authorized_official_last_name": "DADA",
        "authorized_official_first_name": "M",
        "authorized_official_middle_name": "ATIQ",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "979-548-6783",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "212014901",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; 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.