NPIMap

Individual provider Active NPI

Myra Ahmed

  • Family Medicine Physician
  • Grand Prairie, TX
National Provider Identifier
1770071417
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
S8413 Issued in TX
Practice address
2740 N State Highway 360 Ste 100
Grand Prairie, TX 75050-6402
Phone
(972) 606-8300
Fax
(972) 606-4940
NPI assigned
Apr 27, 2018
Last updated
Sep 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

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
Family Medicine Physician 207Q00000X S8413 TX Primary

Addresses

Primary practice location

2740 N State Highway 360 Ste 100
Grand Prairie, TX 75050-6402

Mailing address

2740 N State Highway 360 Ste 100
Grand Prairie, TX 75050-6402
Phone (972) 606-8300

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
I20210528001662 TX Practitioner - Family Practice 9436405693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

2740 N State Hwy 360
Suite 100
Grand Prairie, TX 75050-6409
Phone (214) 820-8500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Healthtexas Provider Network CurrentSince Dec 5, 2022 Accepting new patients
Healthtexas Provider Network Family Medicine CurrentSince Dec 5, 2022 Accepting new patients
Healthtexas Provider Network Family Medicine Current Accepting new patients
Healthtexas Provider Network Family Medicine Past Accepting new patients
Scott & White Hospital - Round Rock PastSince Jul 1, 2021 Accepting new patients

Locations

5408 Colleyville Blvd
Colleyville, TX 76034
Phone (817) 498-9920

4001 Worth St
#A
Dallas, TX 75246
Phone (214) 820-8665

2740 N State Highway 360
Ste 100
Grand Prairie, TX 75050
Phone (972) 606-8300

Interoperability endpoints

  • Direct secure messaging: mahmed830828@direct.sw.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1524787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1770071417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 N STATE HIGHWAY 360 STE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750506402",
            "telephone_number": "972-606-8300",
            "fax_number": "972-606-4940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 N STATE HIGHWAY 360 STE 100",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750506402",
            "telephone_number": "972-606-8300",
            "fax_number": "972-606-4940"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHMED",
        "first_name": "MYRA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-27",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "S8413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

Verify at the official NPI Registry.