Individual provider Active NPI

Gurpreet S Dhaliwal, MD

  • Neurology Physician
  • Burleson, TX
National Provider Identifier
1780601286
Registry record updated Jan 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
A45059 Issued in CA
Practice address
11803 South Fwy
Ste 210
Burleson, TX 76028-7012
Phone
(817) 551-6000
Fax
(817) 551-6008
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X A45059 CA Primary
Neurology Physician 2084N0400X N0728 TX

Addresses

Primary practice location

11803 South Fwy
Ste 210
Burleson, TX 76028-7012

Mailing address

11803 South Fwy
Ste 210
Burleson, TX 76028-7012
Phone (817) 551-6000

Other identifiers 2

IdentifierTypeStateIssuer
00A450590MedicaidCA
46-1012160OtherTXTX ID

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
I20130418000543 TX Practitioner - Neurology 5092902700 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

11787 S Fwy
Suite 350
Burleson, TX 76028-7035

11797 S Fwy 350
Burleson, TX 76028-7035
Phone (817) 551-6000

11801 S Fwy
Burleson, TX 76028-7021
Phone (817) 293-9110

11803 S Fwy 210
Burleson, TX 76028-7036
Phone (817) 551-6000

Hospital & facility affiliations

  • Texas Health Huguley Hospital Fort Worth South Hospital, Fort Worth, TX, CCN 450677

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A45059CAMDNeurology Physician
N0728TXMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gurpreet S Dhaliwal MD P a Neurology CurrentSince Dec 1, 2012 Accepting new patients

Locations

11797 South Fwy
Ste 350
Burleson, TX 76028
Phone (817) 551-1304

11803 South Fwy
Ste 210
Burleson, TX 76028
Phone (817) 551-3812

Organizations & group practices 1

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 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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358985600000",
    "number": "1780601286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11803 SOUTH FWY",
            "address_2": "STE 210",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287012",
            "telephone_number": "817-551-6000",
            "fax_number": "817-551-6008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11803 SOUTH FWY",
            "address_2": "STE 210",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "760287012",
            "telephone_number": "817-551-6000",
            "fax_number": "817-551-6008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHALIWAL",
        "first_name": "GURPREET",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2013-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A45059",
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "TX",
            "license": "N0728",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A450590",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX ID",
            "identifier": "46-1012160",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burleson, TX

Sources for this page

Verify at the official NPI Registry.