NPIMap

Individual provider Active NPI

Ellaheh Ebrahim, M.D.

  • Family Medicine Physician
  • Wichita Falls, TX
National Provider Identifier
1972833754
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
N8909 Issued in TX
Practice address
200 Martin Luther King Blvd
Wichita Falls, TX 76301-1152
Phone
(940) 766-6306
Fax
(940) 766-6504
NPI assigned
Dec 30, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 27109 OK
Chronic Disease Hospital 281P00000X 27109 OK
General Acute Care Hospital 282N00000X 27109 OK
Family Medicine Physician 207Q00000X N8909 TX Primary

Addresses

Primary practice location

200 Martin Luther King Blvd
Wichita Falls, TX 76301-1152

Mailing address

200 Martin Luther King Blvd
Wichita Falls, TX 76301-1152
Phone (940) 766-6306

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
I20160210002921 TX Practitioner - Family Practice 3779746813 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Central Texas Community Health Care Center IncGroup PAC ID 9931099215, 10 clinicians

Practice addresses (Care Compare)

1001 Juarez St
Apt a
Wichita Falls, TX 76301-6971
Phone (940) 766-6306

1620 W Virginia St
Family Health Center on VA
McKinney, TX 75069-7862
Phone (214) 618-5600

200 MLK Jr Blvd
Wichita Falls, TX 76301-1152
Phone (940) 766-6306

Hospital & facility affiliations

  • Angels Care Home Health Home health agency, Wichita Falls, TX, CCN 459298
  • Healing Hands Healthcare LLC Home health agency, Wichita Falls, TX, CCN 677101
  • Beyond Faith Homecare & Rehab of Wichita Falls Home health agency, Wichita Falls, TX, CCN 743162
  • Wichita Home Health Service Inc Home health agency, Wichita Falls, TX, CCN 457047
  • Hospice of Wichita Falls Hospice, Vernon, TX, CCN 451526
  • United Regional Health Care System Hospital, Wichita Falls, TX, CCN 450010

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
N8909TXMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Central Texas Community Health Care Center, Inc Family Medicine Current Accepting new patients
North Central Texas Community Health Care Center, Inc CurrentSince Oct 31, 2015 Accepting new patients
North Central Texas Community Health Care Center, Inc CurrentSince Apr 1, 2015 Accepting new patients
North Central Texas Community Health Care Center Inc. Past Accepting new patients

Locations

4510 Medical Center Dr
Ste 201
McKinney, TX 75069
Phone (972) 562-1000

3713 W 15th St
Ste 401
Plano, TX 75075
Phone (972) 596-5900

4301 College Dr
Rm 600
Vernon, TX 76384
Phone (940) 552-8000

804 Denver St
Wichita Falls, TX 76301
Phone (817) 723-8571

200 Mlk Jr Blvd
Wichita Falls, TX 76301
Phone (940) 397-2609

1000 Juarez St
Bldg A
Wichita Falls, TX 76301

4105 Maplewood Ave
Ste 1000
Wichita Falls, TX 76308

2412 Avenue H
Wichita Falls, TX 76309

Ownership & related parties

All facility ownership & control disclosures 14

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Community Healthcare CenterWichita Falls, TX, CCN 451894 Federally qualified health center Operational/Managerial Control (15%) Apr 1, 2015
Community Healthcare Center-Juarez Medical ClinicWichita Falls, TX, CCN 671943 Federally qualified health center Operational/Managerial Control (15%) Apr 1, 2015
Pediatric AssociatesWichita Falls, TX, CCN 741987 Federally qualified health center Operational/Managerial Control (6.67%) Apr 1, 2015
Women'S Health Center of McKinneyMcKinney, TX, CCN 451061 Federally qualified health center Operational/Managerial Control (15%) Apr 1, 2015
North Central Texas Community Health Care Center IncWichita Falls, TX, CCN 451102 Federally qualified health center Operational/Managerial Control (4%) Apr 1, 2015
Community Healthcare Center at Vernon College Wichita FallsWichita Falls, TX, CCN 451114 Federally qualified health center Operational/Managerial Control (4%) Apr 1, 2015
North Central Texas Community Health Care Center IncWichita Falls, TX, CCN 451131 Federally qualified health center Operational/Managerial Control (4%) Apr 1, 2015
Family Health Center on VirginiaMcKinney, TX, CCN 451128 Federally qualified health center Operational/Managerial Control (4%) Apr 1, 2015
North Central Texas Community Health Care Center IncVernon, TX, CCN 451143 Federally qualified health center Operational/Managerial Control (4%) Apr 1, 2015
Phyllis Hiraki Dental ClinicWichita Falls, TX, CCN 451193 Federally qualified health center Operational/Managerial Control (4%) Apr 1, 2015
Women'S Health Center of PlanoPlano, TX, CCN 671054 Federally qualified health center Operational/Managerial Control (4%) Apr 1, 2015
Club Health Center of VernonVernon, TX, CCN 671078 Federally qualified health center Operational/Managerial Control (15%) Apr 1, 2015
Pediatric Associates 10TH StreetWichita Falls, TX, CCN 671092 Federally qualified health center Operational/Managerial Control (15%) Apr 1, 2015
CHC at Wilbarger GeneralVernon, TX, CCN 971043 Federally qualified health center Operational/Managerial Control (15%) Jul 29, 2015

Owned or controlled facilities with NPI records 14

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

View all 14

Organizations & group practices 4

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 6

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": "1262131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1972833754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MARTIN LUTHER KING BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763011152",
            "telephone_number": "940-766-6306",
            "fax_number": "940-766-6504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 MARTIN LUTHER KING BLVD",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763011152",
            "telephone_number": "940-766-6306",
            "fax_number": "940-766-6504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EBRAHIM",
        "first_name": "ELLAHEH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-12-30",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OK",
            "license": "27109",
            "primary": false
        },
        {
            "code": "281P00000X",
            "taxonomy_group": "",
            "desc": "Chronic Disease Hospital",
            "state": "OK",
            "license": "27109",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "OK",
            "license": "27109",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "N8909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.