NPIMap

Organization Active NPI

DFW Family Clinic

  • Medical Physician Assistant
  • Grand Prairie, TX
National Provider Identifier
1962881441
Registry record updated May 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA09381 Issued in TX
Legal business name
DFW FAMILY CLINIC
Practice address
2771 Sherman St
Grand Prairie, TX 75051-6016
Phone
(972) 647-0550
NPI assigned
May 29, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2015

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

Authorized official

Name
Dr. Adila N. Siddiqi, D.O.NPI 1932180296
Title
Physician
Phone
(972) 647-0550

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
Medical Physician AssistantGroup: 193400000X SINGLE SPECIALTY GROUP 363AM0700X PA09381 TX Primary

Addresses

Primary practice location

2771 Sherman St
Grand Prairie, TX 75051-6016

Mailing address

2771 Sherman St
Grand Prairie, TX 75051-6016
Phone (972) 647-0550

Other identifiers 1

IdentifierTypeStateIssuer
PA09381OtherTXPHYSICIAN ASSISTANT PERMIT

National Provider Directory

National Provider Directory
Tax ID family
DFW Family Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1432857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432857600000",
    "number": "1962881441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2771 SHERMAN ST",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750516016",
            "telephone_number": "972-647-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2771 SHERMAN ST",
            "city": "GRAND PRAIRIE",
            "state": "TX",
            "postal_code": "750516016",
            "telephone_number": "972-647-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DFW FAMILY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-29",
        "last_updated": "2015-05-29",
        "status": "A",
        "authorized_official_last_name": "SIDDIQI",
        "authorized_official_first_name": "ADILA",
        "authorized_official_middle_name": "N.",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "972-647-0550",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA09381",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIAN ASSISTANT PERMIT",
            "identifier": "PA09381",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Prairie, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2015; 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.