Active NPI
Lida Aghdam, MD
- Internal Medicine Physician
- The Colony, TX
National Provider Identifier
1376572115
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- L4208
- Practice address
- 4819 State Highway 121 Ste 14
The Colony, TX 75056-2908 - Phone
- (817) 488-7878
- Fax
- (817) 488-7877
- NPI assigned
- Jul 2, 2006
- Last updated
- Aug 4, 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | L4208 | TX | Primary |
Addresses
Primary practice location
4819 State Highway 121 Ste 14
The Colony, TX 75056-2908
Mailing address
4819 State Highway 121 Ste 14
The Colony, TX 75056-2908
Phone (817) 488-7878
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: Yes
- Opted out of Medicare
- Yes, effective Jan 1, 2017 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physicians and Allied Health Professionals Group, PA | Internal Medicine | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Family Medicine Physician
- Dallas, TX
- NPI 1528011814
Internal Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151798400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691107200000",
"number": "1376572115",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4819 STATE HIGHWAY 121 STE 14",
"city": "THE COLONY",
"state": "TX",
"postal_code": "750562908",
"telephone_number": "817-488-7878",
"fax_number": "817-488-7877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4819 STATE HIGHWAY 121 STE 14",
"city": "THE COLONY",
"state": "TX",
"postal_code": "750562908",
"telephone_number": "817-488-7878",
"fax_number": "817-488-7877"
}
],
"practiceLocations": [],
"basic": {
"last_name": "AGHDAM",
"first_name": "LIDA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-02",
"last_updated": "2023-08-04",
"certification_date": "2023-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "TX",
"license": "L4208",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in The Colony, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2023; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.