Individual provider Active NPI

Khaled Mohammad Al-Hreish

  • Internal Medicine Physician
  • Dallas, TX
National Provider Identifier
1699355941
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
V0676 Issued in TX
Practice address
3500 Gaston Ave
Dallas, TX 75246-2017
Phone
(214) 820-2361
NPI assigned
Apr 12, 2021
Last updated
Nov 21, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X V0676 TX Primary

Addresses

Primary practice location

3500 Gaston Ave
Dallas, TX 75246-2017

Mailing address

10101 Carano CT
Irving, TX 75063-5943

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241218001147 TX Practitioner - Internal Medicine 5991104648 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

3600 Gaston Ave
Suite 550
Dallas, TX 75246-1905
Phone (972) 451-0219

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
V0676TXMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Jan 13, 2025 Accepting new patients
Healthtexas Provider Network Internal Medicine Current Accepting new patients
Healthtexas Provider Network CurrentSince Jan 13, 2025 Accepting new patients
Baylor University Medical Center Past Accepting new patients

Locations

301 N Washington Ave
Fl 5
Dallas, TX 75246
Phone (469) 800-8742

3500 Gaston Ave
Dallas, TX 75246

3600 Gaston Ave
Ste 550
Dallas, TX 75246
Phone (214) 821-1177

4001 Worth St
Dallas, TX 75246
Phone (214) 828-1745

Interoperability endpoints

  • Direct secure messaging: kalhreish827715@direct.sw.org

Organizations & group practices 4

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": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1699355941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10101 CARANO CT",
            "city": "IRVING",
            "state": "TX",
            "postal_code": "750635943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 GASTON AVE",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752462017",
            "telephone_number": "214-820-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL-HREISH",
        "first_name": "KHALED",
        "middle_name": "MOHAMMAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-12",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "V0676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.