NPIMap

Organization Active NPI

Jawad a Qureshi MD PA

  • Ophthalmology Physician
  • Southlake, TX
National Provider Identifier
1881994713
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
JAWAD A QURESHI MD PA
Practice address
305 Morrison Park Dr Ste 100
Southlake, TX 76092-1352
Phone
(817) 865-6800
Fax
(817) 865-6790
NPI assigned
Oct 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

Authorized official

Name
Jawad A Qureshi, MDNPI 1811926769
Title
President
Phone
(817) 975-6398

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

305 Morrison Park Dr Ste 100
Southlake, TX 76092-1352

Mailing address

PO Box 975673
Dallas, TX 75397-5673
Phone (972) 791-1224

Other practice location 1

3804 W 15th St Ste 130
Plano, TX 75075-4752
Phone (817) 865-6800

Other practice location 2

3455 Locke Ave Ste 310
Fort Worth, TX 76107-5747
Phone (817) 865-6800

Other practice location 3

12222 N Central Expy Ste 250
Dallas, TX 75243-3762
Phone (817) 865-6800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110517000265 TX Part B Supplier - Clinic/Group Practice 6406032036 Receives reassigned benefits from 7 practitioners
Practice locations: Dallas, TX; Fort Worth, TX; Plano, TX; Southlake, TX

National Provider Directory

National Provider Directory

Locations

12222 N Central Expy
Ste 250
Dallas, TX 75243
Phone (817) 865-6800

3455 Locke Ave
Ste 310
Fort Worth, TX 76107
Phone (817) 865-6800

2321 Ira E Woods Ave
Ste 200
Grapevine, TX 76051
Phone (817) 865-6800

3804 W 15th St
Ste 130
Plano, TX 75075
Phone (817) 865-6800

Interoperability endpoints

  • Direct secure messaging: msiddiqui@rctx.intellechartdirect.net
  • Direct secure messaging: omoinuddin@rctx.intellechartdirect.net
  • Direct secure messaging: jwarminski@rctx.intellechartdirect.net
  • Direct secure messaging: lpatel@rctx.intellechartdirect.net
  • Direct secure messaging: mabdelaziz@rctx.intellechartdirect.net
  • Direct secure messaging: jqureshi@rctx.intellechartdirect.net
  • Direct secure messaging: mrunner@rctx.intellechartdirect.net

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701388800000",
    "number": "1881994713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 975673",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753975673",
            "telephone_number": "972-791-1224",
            "fax_number": "972-819-0050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MORRISON PARK DR STE 100",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760921352",
            "telephone_number": "817-865-6800",
            "fax_number": "817-865-6790"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3804 W 15th St Ste 130",
            "address_purpose": "LOCATION",
            "city": "Plano",
            "state": "TX",
            "postal_code": "750754752",
            "country_code": "US",
            "telephone_number": "817-865-6800",
            "fax_number": "817-865-6790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3455 Locke Ave Ste 310",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761075747",
            "country_code": "US",
            "telephone_number": "817-865-6800",
            "fax_number": "817-865-6790",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12222 N Central Expy Ste 250",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "752433762",
            "country_code": "US",
            "telephone_number": "817-865-6800",
            "fax_number": "817-865-6790",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "JAWAD A QURESHI MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-26",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "status": "A",
        "authorized_official_last_name": "QURESHI",
        "authorized_official_first_name": "JAWAD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "817-975-6398",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southlake, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.