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NPI Code Detail

MEDICARE: DR. KHUBAIB NAZIR GONDAL M.D.

MEDICARE: DR. KHUBAIB NAZIR GONDAL M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician301003NY
2207RN0300XNephrology PhysicianT9397TX
3208M00000XHospitalist Physician35.136515OH
4207R00000XInternal Medicine PhysicianT9397TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1437512753
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KHUBAIB NAZIR GONDAL M.D.
Provider Business Mailing Address
First Line : 7406 QUAIL RIDGE DR
Second Line :
City : ARLINGTON
State : TX
Zip : 76002-3484
Country : US
Telephone Number : 347-432-0944
Fax Number :
Provider Business Practice Location Address
First Line : 2300 LONE STAR RD
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-8744
Country : US
Telephone Number : 682-341-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/04/2016
Last Update Date : 10/02/2024

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