Organization Active NPI

Dallas Lung Care

  • Pulmonary Disease Physician
  • Rockwall, TX
National Provider Identifier
1346910379
Registry record updated Aug 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
DALLAS LUNG CARE
Practice address
2504 Ridge Rd Ste 206
Rockwall, TX 75087-2571
Phone
(304) 634-5523
NPI assigned
Sep 21, 2021
Last updated
Aug 8, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2022

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

Authorized official

Name
Dr. Abdel Rahman Lataifeh
Title
Physician and Managing Member
Phone
(214) 304-7669

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU
Pulmonary Disease Physician 207RP1001X NU Primary

Addresses

Primary practice location

2504 Ridge Rd Ste 206
Rockwall, TX 75087-2571

Mailing address

2504 Ridge Rd Ste 206
Rockwall, TX 75087-2571
Phone (214) 304-7669

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220203000740 TX Part B Supplier - Clinic/Group Practice 8426441049 Receives reassigned benefits from 3 practitioners
Practice locations: Rockwall, TX

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1632182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659916800000",
    "number": "1346910379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2504 RIDGE RD STE 206",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750872571",
            "telephone_number": "214-304-7669",
            "fax_number": "214-764-7757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 RIDGE RD STE 206",
            "city": "ROCKWALL",
            "state": "TX",
            "postal_code": "750872571",
            "telephone_number": "304-634-5523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DALLAS LUNG CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-21",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A",
        "authorized_official_last_name": "LATAIFEH",
        "authorized_official_first_name": "ABDEL RAHMAN",
        "authorized_official_title_or_position": "PHYSICIAN AND MANAGING MEMBER",
        "authorized_official_telephone_number": "214-304-7669",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockwall, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.