Individual provider Active NPI

Munawwer Khurshid, M.D.

  • Neurology Physician
  • Nacogdoches, TX
National Provider Identifier
1699733378
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
K4930 Issued in TX
Practice address
1018 N Mound St Ste 201
Nacogdoches, TX 75961-4434
Phone
(936) 564-3538
Fax
(936) 564-3546
NPI assigned
May 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X K4930 TX
Sleep Medicine (Psychiatry & Neurology) Physician 2084S0012X K4930 TX
Neurology Physician 2084N0400X K4930 TX Primary

Addresses

Primary practice location

1018 N Mound St Ste 201
Nacogdoches, TX 75961-4434

Mailing address

1204 N Mound St
Nacogdoches, TX 75961-4027
Phone (936) 568-8425

Other practice location 1

910 E Houston St
Suite 330
Tyler, TX 75702-8369
Phone (903) 525-7995

Other practice location 2

1600 Wallace Blvd
Amarillo, TX 79106-1799
Phone (806) 212-2129

Other practice location 3

700 E Marshall Ave
Longview, TX 75601-5580
Phone (903) 315-1488

Other practice location 4

701 E Marshall Ave Ste 400
Longview, TX 75601-5595
Phone (903) 315-2714

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
I20050811000989 TX Practitioner - NeurologyPractitioner - General PracticePractitioner - Family PracticePractitioner - Other (Physician) 3274562905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lion Star Nacogdoches Hospital, LLCGroup PAC ID 3971992082, 12 clinicians
Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

1018 N Mound St
Suite 101
Nacogdoches, TX 75961-4434
Phone (936) 564-3538

620 S Fleishel Ave
Christus Trinity Clinic
Tyler, TX 75701-2041
Phone (903) 606-4900

630 S Fleishel Ave
Tyler, TX 75701-2041
Phone (903) 606-5560

700 E Marshall Ave
Christus Trinity Clinic
Longview, TX 75601-5580
Phone (903) 315-1488

Hospital & facility affiliations

  • Vitalcaring Group Home health agency, Henderson, TX, CCN 458072
  • Nacogdoches Memorial Hospital Hospital, Nacogdoches, TX, CCN 450508
  • Christus Good Shepherd Medical Center Hospital, Longview, TX, CCN 450032
  • CHI St Lukes Health Memorial Lufkin Hospital, Lufkin, TX, CCN 450211
  • CHI St Lukes Health Memorial San Augustine Hospital, San Augustine, TX, CCN 670783

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Christus Trinity Clinic Texas Internal Medicine CurrentSince Jan 11, 2016 Accepting new patients
Lion Star Nacogdoches Hospital, LLC CurrentSince Sep 11, 2023 Accepting new patients
Lion Star Nacogdoches Hospital, LLC Internal Medicine CurrentSince Sep 11, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Jan 11, 2016 Accepting new patients
C H Wilkinson Physician Network Internal Medicine Past Accepting new patients

Locations

1276 S Peachtree St
Jasper, TX 75951
Phone (409) 384-5701

701 E Marshall Ave
Ste 400
Longview, TX 75601
Phone (903) 315-1696

700 E Marshall Ave
Longview, TX 75601
Phone (903) 236-2000

1018 N Mound St
Ste 205
Nacogdoches, TX 75961
Phone (936) 560-0707

1002 N Mound St
Nacogdoches, TX 75961
Phone (936) 560-3800

1023 N Mound St
Ste B
Nacogdoches, TX 75961
Phone (936) 559-0800

1204 N Mound St
Nacogdoches, TX 75961
Phone (936) 564-4611

1018 N Mound St
Ste 201
Nacogdoches, TX 75961
Phone (936) 560-2763

1108 South St
Nacogdoches, TX 75964
Phone (936) 560-3097

1018 N Mound St
Ste 101
Nacogdoches, TX 75961
Phone (365) 604-4259

910 E Houston St
Ste 330
Tyler, TX 75702
Phone (903) 510-8718

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

Interoperability endpoints

  • Direct secure messaging: munawwer.khurshid@ncfg.eclinicaldirectplus.com
  • FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4

Organizations & group practices 5

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

Hospital & facility affiliations 5

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": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1699733378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 N MOUND ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614027",
            "telephone_number": "936-568-8425",
            "fax_number": "806-212-6278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1018 N MOUND ST STE 201",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759614434",
            "telephone_number": "936-564-3538",
            "fax_number": "936-564-3546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 E Houston St",
            "address_2": "Suite 330",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757028369",
            "country_code": "US",
            "telephone_number": "903-525-7995",
            "fax_number": "903-525-1750",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1600 Wallace Blvd",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791061799",
            "country_code": "US",
            "telephone_number": "806-212-2129",
            "fax_number": "806-212-2246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "700 E Marshall Ave",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015580",
            "country_code": "US",
            "telephone_number": "903-315-1488",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 E Marshall Ave Ste 400",
            "address_purpose": "LOCATION",
            "city": "Longview",
            "state": "TX",
            "postal_code": "756015595",
            "country_code": "US",
            "telephone_number": "903-315-2714",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KHURSHID",
        "first_name": "MUNAWWER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-03",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "K4930",
            "primary": false
        },
        {
            "code": "2084S0012X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Sleep Medicine",
            "state": "TX",
            "license": "K4930",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "K4930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

Verify at the official NPI Registry.