Organization Active NPI

Medical Associates of Dallas PLLC

  • Clinic/Center
  • Dallas, TX
National Provider Identifier
1336799618
Registry record updated Jan 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
MEDICAL ASSOCIATES OF DALLAS PLLC
Practice address
6380 LBJ Fwy Ste 290
Dallas, TX 75240-6416
Phone
(972) 991-1153
NPI assigned
Sep 18, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2026

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

Authorized official

Name
Gholamreza Assadollah, FNP
Title
Sole Member
Phone
(469) 503-1916

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

6380 LBJ Fwy Ste 290
Dallas, TX 75240-6416

Mailing address

PO Box 794564
Dallas, TX 75379-4564

Other practice location 1

2121 N Main St Ste 404
Fort Worth, TX 76164-8588
Phone (817) 624-7222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200504001637 TX Part B Supplier - Clinic/Group Practice 1052742210 Receives reassigned benefits from 1 practitioner
Practice locations: Dallas, TX

National Provider Directory

National Provider Directory

Locations

12870 Hillcrest Rd
Ste H201
Dallas, TX 75230

2121 N Main St
Ste 404
Fort Worth, TX 76164
Phone (817) 624-7222

907 Custer Rd
Richardson, TX 75080

Practitioners & affiliated clinicians

Practitioners 2

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": "1568764800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769472000000",
    "number": "1336799618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 794564",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753794564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6380 LBJ FWY STE 290",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752406416",
            "telephone_number": "972-991-1153"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2121 N Main St Ste 404",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761648588",
            "country_code": "US",
            "telephone_number": "817-624-7222",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF DALLAS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-18",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A",
        "authorized_official_last_name": "ASSADOLLAH",
        "authorized_official_first_name": "GHOLAMREZA",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "469-503-1916",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "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 Jan 27, 2026; 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.