NPIMap

Organization Active NPI

Heal 360 Primary Care PLLC

  • General Practice Physician
  • Wylie, TX
National Provider Identifier
1588022800
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
HEAL 360 PRIMARY CARE PLLC
Practice address
2806 W FM 544
Wylie, TX 75098-7022
Phone
(972) 226-8900
Fax
(972) 218-0554
NPI assigned
Feb 1, 2016
Last updated
Aug 11, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Authorized official

Name
Dr. Mohammed MohiuddinNPI 1942308424
Title
Ceo
Phone
(972) 900-6009

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
General Practice Physician 208D00000X NU Primary

Addresses

Primary practice location

2806 W FM 544
Wylie, TX 75098-7022

Mailing address

1313 Bravura Dr
Plano, TX 75074-0107
Phone (972) 226-8900

Other practice location 1

3320 Lavon Dr
Garland, TX 75040-2910
Phone (972) 200-2595

Other practice location 2

940 W Stacy Rd Ste 110
Allen, TX 75013-5215
Phone (214) 833-3100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160419000582 TX Part B Supplier - Clinic/Group Practice 4688972052 Receives reassigned benefits from 24 practitioners
Practice locations: Garland, TX; Plano, TX; Wylie, TX

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
45D2111380Heal 360 Primary Care, PLLC2806 E FM 544, Wylie, TX 75098Certificate of waiverJul 20, 2026

National Provider Directory

National Provider Directory

Locations

3320 Lavon Dr
Garland, TX 75040
Phone (972) 200-2595

4013 14th St
#401B
Plano, TX 75074

4013 14th St
Ste 401B
Plano, TX 75074

3400 W FM 544
Ste 650B
Wylie, TX 75098
Phone (972) 301-7596

Practitioners & affiliated clinicians

Practitioners 25

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.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1454284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691712000000",
    "number": "1588022800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 BRAVURA DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750740107",
            "telephone_number": "972-226-8900",
            "fax_number": "469-861-8625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2806 W FM 544",
            "city": "WYLIE",
            "state": "TX",
            "postal_code": "750987022",
            "telephone_number": "972-226-8900",
            "fax_number": "972-218-0554"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3320 Lavon Dr",
            "address_purpose": "LOCATION",
            "city": "Garland",
            "state": "TX",
            "postal_code": "750402910",
            "country_code": "US",
            "telephone_number": "972-200-2595",
            "fax_number": "972-218-0554",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "940 W Stacy Rd Ste 110",
            "address_purpose": "LOCATION",
            "city": "Allen",
            "state": "TX",
            "postal_code": "750135215",
            "country_code": "US",
            "telephone_number": "214-833-3100",
            "fax_number": "972-992-2428",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "HEAL 360 PRIMARY CARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-01",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A",
        "authorized_official_last_name": "MOHIUDDIN",
        "authorized_official_first_name": "MOHAMMED",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "972-900-6009",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wylie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.