NPIMap

Organization Active NPI

Ghadir Issa MD PA

  • Pediatrics Physician
  • Desoto, TX
National Provider Identifier
1396920922
Registry record updated Mar 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
J5165 Issued in TX
Legal business name
GHADIR ISSA MD PA
Practice address
947 Scotland Drive
Suite 101
Desoto, TX 75115-2093
Phone
(214) 217-4011
Fax
(214) 217-4016
NPI assigned
Jan 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2019

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

Authorized official

Name
Dr. Ghadir A Issa, MDNPI 1720035298
Title
President
Phone
(214) 217-4011

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X J5165 TX Primary

Addresses

Primary practice location

947 Scotland Drive
Suite 101
Desoto, TX 75115-2093

Mailing address

947 Scotland Drive
Suite 101
Desoto, TX 75115-2093
Phone (214) 217-4011

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
45D0942237Ghadir a Issa MD947 Scotland Drive Suite 101, Desoto, TX 75115Certificate of waiverMar 8, 2028

National Provider Directory

National Provider Directory

Locations

947 Scotland Dr
Ste 101
Desoto, TX 75115
Phone (214) 217-4011

Practitioners & affiliated clinicians

Practitioners 4

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": "1199232000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551398400000",
    "number": "1396920922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 SCOTLAND DRIVE",
            "address_2": "SUITE 101",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152093",
            "telephone_number": "214-217-4011",
            "fax_number": "214-217-4016"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 SCOTLAND DRIVE",
            "address_2": "SUITE 101",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751152093",
            "telephone_number": "214-217-4011",
            "fax_number": "214-217-4016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GHADIR ISSA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-02",
        "last_updated": "2019-03-01",
        "status": "A",
        "authorized_official_last_name": "ISSA",
        "authorized_official_first_name": "GHADIR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-217-4011",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "J5165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.