NPIMap

Organization Active NPI

Charles a Iliya MD PA

  • Surgery Physician
  • Dallas, TX
National Provider Identifier
1639446891
Registry record updated Aug 20, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
G5202 Issued in TX
Legal business name
CHARLES A ILIYA MD PA
Practice address
9330 Poppy Dr
Suite 500
Dallas, TX 75218-4612
Phone
(214) 321-2481
Fax
(214) 324-1478
NPI assigned
Nov 16, 2011
Last updated
Aug 20, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2016

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

Authorized official

Name
Dr. Charles A Iliya, M.D.
Title
President
Phone
(214) 321-2481

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X G5202 TX Primary
Vascular Surgery Physician 2086S0129X G5202 TX

Addresses

Primary practice location

9330 Poppy Dr
Suite 500
Dallas, TX 75218-4612

Mailing address

9330 Poppy Dr
Suite 500
Dallas, TX 75218-4612
Phone (214) 321-2481

National Provider Directory

National Provider Directory

Locations

1151 N Buckner Blvd
Ste 202
Dallas, TX 75218
Phone (214) 321-2481

Practitioners & affiliated clinicians

Practitioners 10

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": "1321401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471651200000",
    "number": "1639446891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9330 POPPY DR",
            "address_2": "SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752184612",
            "telephone_number": "214-321-2481",
            "fax_number": "214-324-1478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9330 POPPY DR",
            "address_2": "SUITE 500",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752184612",
            "telephone_number": "214-321-2481",
            "fax_number": "214-324-1478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES A ILIYA MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-16",
        "last_updated": "2016-08-20",
        "status": "A",
        "authorized_official_last_name": "ILIYA",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "214-321-2481",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "G5202",
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "TX",
            "license": "G5202",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2016; 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.