Prime Neurology PLLC

Key facts

NPI

1619734993

Entity type

Organization (NPI type 2)

Primary specialty

Neurology Physician 2084N0400X

Legal business name

PRIME NEUROLOGY PLLC

Practice address

6800 N Macarthur Blvd
Irving, TX 75039-2422

Phone

(972) 246-8563

Fax

(940) 243-0404

NPI assigned

Mar 4, 2024

Organization subpart

No

Authorized official

Name

Mr. Mohamed Summakia, MD NPI 1962430553

Title

President

Phone

(469) 323-8112

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

Practitioners 1

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

• Mohamed Summakia, M.D. Neurology Physician · Denton, TX · NPI 1962430553
  Medicare reassignment Authorized official TX

Medicare participation

Medicare fee-for-service enrollment

Enrolled in TX

Medicare enrollment records

National Provider Directory

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 4, 2024.

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709510400000",
    "number": "1619734993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9607 VALLEY LAKE LN",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750635014",
            "telephone_number": "469-323-8112",
            "fax_number": "940-243-0404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6800 N MACARTHUR BLVD",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750392422",
            "telephone_number": "972-246-8563",
            "fax_number": "940-243-0404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME NEUROLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-03",
        "status": "A",
        "authorized_official_last_name": "SUMMAKIA",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "469-323-8112",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Irving, TX · Neurology Physician in Texas