Organization Active NPI

Advanced Medical Associates, LLC

  • Primary Care Clinic/Center
  • Richardson, TX
National Provider Identifier
1407151541
Registry record updated Jan 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
M5617 Issued in TX
Legal business name
ADVANCED MEDICAL ASSOCIATES, LLC
Practice address
1381 Lake Park Way
Richardson, TX 75080
Phone
(214) 356-8716
NPI assigned
Jan 21, 2011
Last updated
Jan 21, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2011

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

Authorized official

Name
Mr. Furqan Khan
Title
Manager
Phone
(469) 834-0722

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X M5617 TX Primary

Addresses

Primary practice location

1381 Lake Park Way
Richardson, TX 75080

Mailing address

811 Farmers Market Way
Dallas, TX 75201-8473

National Provider Directory

National Provider Directory

Locations

1381 Lake Park Way
Richardson, TX 75080
Phone (214) 356-8716

Practitioners & affiliated clinicians

Practitioners 1

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": "1295568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295568000000",
    "number": "1407151541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 FARMERS MARKET WAY",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752018473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1381 LAKE PARK WAY",
            "city": "RICHARDSON",
            "state": "TX",
            "postal_code": "75080",
            "telephone_number": "214-356-8716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED MEDICAL ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-21",
        "last_updated": "2011-01-21",
        "status": "A",
        "authorized_official_last_name": "KHAN",
        "authorized_official_first_name": "FURQAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "469-834-0722",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "TX",
            "license": "M5617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richardson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.