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General NPI Number Information
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NPI Number | 1881103489
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Entity Type | Organization
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Legal Business Name | DALLAS ORTHOPEDIC ASSOCIATES PLLC
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 04/27/2022
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Provider Practice Location Address
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Address Line | 1102 N GALLOWAY AVE
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City | MESQUITE
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State | TX
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Zip | 75149-2436
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Country | US
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Telephone | 469-518-7853
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Fax | 469-232-9917
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Provider Business Mailing Address
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Address Line | 10455 N CENTRAL EXPY STE 109-125
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City | DALLAS
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State | TX
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Zip | 75231-2213
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Country | US
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Telephone | 469-518-7853
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Fax | 469-232-9917
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. KHAWAJA NIMR IKRAM
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Credential | DO
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Telephone | 469-404-9488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | 10814
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | P0984
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License Number State | TX
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