NPIMap

Individual provider Active NPI

Dallal W Abdelsayed, M.D.

  • Family Medicine Physician
  • Highlands, TX
National Provider Identifier
1649345216
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
G6694 Issued in TX
Practice address
607 E Wallisville Rd
Highlands, TX 77562-3831
Phone
(281) 426-8586
Fax
(281) 426-7983
NPI assigned
Nov 21, 2006
Last updated
Jun 30, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X G6694 TX Primary

Addresses

Primary practice location

607 E Wallisville Rd
Highlands, TX 77562-3831

Mailing address

607 E Wallisville Rd
Highlands, TX 77562-3831
Phone (281) 426-8586

Other identifiers 2

IdentifierTypeStateIssuer
121191402MedicaidTX
4388704OtherTXAETNA PROVIDER #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110318000373 TX Practitioner - Family Practice 7416054416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Highlands Medical Associates, P.aGroup PAC ID 5890965529, 2 clinicians

Practice addresses (Care Compare)

607 E Wallisville Rd
Highlands, TX 77562-3831
Phone (281) 426-8586

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Highlands Medical Associates, P.a. Family Medicine CurrentSince May 10, 2011 Accepting new patients
Serenity Care Solutions LLC Family Medicine CurrentSince Sep 1, 2020 Accepting new patients
Serenity Care Solutions LLC Current Accepting new patients

Locations

607 E Wallisville Rd
Highlands, TX 77562
Phone (281) 426-8586

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Serenity Care Solutions LLCHighlands, TX, CCN 748191 Home health agency 5% Or Greater Direct Ownership Interest (50%) Sep 1, 2019
Serenity Care Solutions LLCHighlands, TX, CCN 971684 Hospice 5% Or Greater Direct Ownership Interest (50%)
General Partnership Interest (50%)		 Sep 1, 2020
Sep 1, 2020

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1649345216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 E WALLISVILLE RD",
            "city": "HIGHLANDS",
            "state": "TX",
            "postal_code": "775623831",
            "telephone_number": "281-426-8586",
            "fax_number": "281-426-7983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 E WALLISVILLE RD",
            "city": "HIGHLANDS",
            "state": "TX",
            "postal_code": "775623831",
            "telephone_number": "281-426-8586",
            "fax_number": "281-426-7983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDELSAYED",
        "first_name": "DALLAL",
        "middle_name": "W",
        "name_prefix": "Mrs.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G6694",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121191402",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER #",
            "identifier": "4388704",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Highlands, TX

Sources for this page

Verify at the official NPI Registry.