Organization Active NPI

Nadia Malik M.D PA

  • Internal Medicine Physician
  • Grapevine, TX
National Provider Identifier
1497026751
Registry record updated Dec 28, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
M9478 Issued in TX
Legal business name
NADIA MALIK M.D PA
Practice address
4100 Heritage Ave Ste 105
Grapevine, TX 76051-5716
Phone
(682) 999-8446
NPI assigned
Jan 18, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2019

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

Authorized official

Name
Dr. Nadia Malik, MDNPI 1891834172
Title
Owner
Phone
(817) 458-1525

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
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X M9478 TX Primary

Addresses

Primary practice location

4100 Heritage Ave Ste 105
Grapevine, TX 76051-5716

Mailing address

1009 High Hawk TRL
Euless, TX 76039-5837
Phone (817) 458-1525

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120927000640 TX Part B Supplier - Clinic/Group Practice 4183873649 Receives reassigned benefits from 1 practitioner
Practice locations: Grapeview, TX

National Provider Directory

National Provider Directory

Locations

4100 Heritage Ave
Ste 105
Grapevine, TX 76051
Phone (682) 999-8446

4100 Heritage Ave
Ste 102
Grapevine, TX 76051
Phone (682) 999-8446

Practitioners & affiliated clinicians

Practitioners 1

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": "1326844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1577491200000",
    "number": "1497026751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 HIGH HAWK TRL",
            "city": "EULESS",
            "state": "TX",
            "postal_code": "760395837",
            "telephone_number": "817-458-1525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 HERITAGE AVE STE 105",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760515716",
            "telephone_number": "682-999-8446"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NADIA MALIK M.D PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-18",
        "last_updated": "2019-12-28",
        "certification_date": "2019-12-28",
        "status": "A",
        "authorized_official_last_name": "MALIK",
        "authorized_official_first_name": "NADIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-458-1525",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "M9478",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2019; 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.