Ideal Infectious Disease &Wound Care Center PLLC

Primary specialty

Infectious Disease PhysicianTaxonomy code 207RI0200X

Legal business name

IDEAL INFECTIOUS DISEASE &WOUND CARE CENTER PLLC

Practice address

4105 Highway 121 Ste 604
Bedford, TX 76021-3039

Phone

(682) 738-3835

Fax

(682) 738-3834

NPI assigned

Jun 10, 2020

Organization subpart

No

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

Authorized official

Name

Khawar Khurshid, MD

Title

Owner

Phone

(682) 738-3835

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1700401262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 HIGHWAY 121 STE 604",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760213039",
            "telephone_number": "682-738-3835",
            "fax_number": "682-738-3834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 HIGHWAY 121 STE 604",
            "city": "BEDFORD",
            "state": "TX",
            "postal_code": "760213039",
            "telephone_number": "682-738-3835",
            "fax_number": "682-738-3834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL INFECTIOUS DISEASE &WOUND CARE CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-10",
        "last_updated": "2023-03-07",
        "certification_date": "2020-06-10",
        "status": "A",
        "authorized_official_last_name": "KHURSHID",
        "authorized_official_first_name": "KHAWAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "682-738-3835",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Infectious Disease",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "R4861",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Infectious Disease Physician in Bedford, TX
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.