Id Physician Consultation Service PLLC

Primary specialty

SpecialistTaxonomy code 174400000X

License

M7840 Issued in TX

Legal business name

ID PHYSICIAN CONSULTATION SERVICE PLLC

Practice address

716 Bedell LN
Murphy, TX 75094-4260

Phone

(214) 914-6873

NPI assigned

Feb 8, 2010

Organization subpart

No

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

Authorized official

Name

Mohanad Bakleh, M.DNPI 1942281415

Title

Physician

Phone

(214) 914-6873

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mohanad Bakleh, MD

  • Internal Medicine Physician
  • Greenville, TX
  • NPI 1942281415
  Medicare reassignment NPD Authorized official
• Alisha Devaun, AGACNP-BC

  • Acute Care Nurse Practitioner
  • Greenville, TX
  • NPI 1609272509
  Medicare reassignment NPD
• Lori Ann Ehrman, APRN, FNP-C

  • Family Nurse Practitioner
  • Princeton, TX
  • NPI 1003457656
  Medicare reassignment NPD
• Rebecca Adelaide Newton, NP

  • Family Nurse Practitioner
  • Garland, TX
  • NPI 1073105557
  Medicare reassignment NPD
• Elizabeth J Wiley, FNP

  • Family Nurse Practitioner
  • Greenville, TX
  • NPI 1194797712
  Medicare reassignment NPD

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

{
    "created_epoch": "1265587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273449600000",
    "number": "1578895116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 BEDELL LN",
            "city": "MURPHY",
            "state": "TX",
            "postal_code": "750944260",
            "telephone_number": "214-914-6873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 BEDELL LN",
            "city": "MURPHY",
            "state": "TX",
            "postal_code": "750944260",
            "telephone_number": "214-914-6873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ID PHYSICIAN CONSULTATION SERVICE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-08",
        "last_updated": "2010-05-10",
        "status": "A",
        "authorized_official_last_name": "BAKLEH",
        "authorized_official_first_name": "MOHANAD",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "214-914-6873",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "M7840",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Human & Co. Wellness
• Tekarra Humphreys, OD
• Aisha Hussain Salam
• Huynh Health & Beauty LLC (AZURA Pharmacy)
• I&M Optics LLC (My EyeLab)
• Ideal Dental of Murphy PLLC (Murphy Center Dental)
• Ideal Physical Therapy of Texas LLC
• Elsie C.O Ifediora, REGISTERED NURSE
• Falih Mohammad Ikram, CPHT, EMT-B
• Heba Indrias

• Specialist in Murphy, TX
• Providers in Murphy, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2010; 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.