Provider Demographics
NPI:1467000828
Name:NTKC-DFW, PLLC
Entity Type:Organization
Organization Name:NTKC-DFW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:AMMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:AL-LAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-375-0610
Mailing Address - Street 1:3801 WILLIAM D TATE AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:GRAPEVINE
Mailing Address - State:TX
Mailing Address - Zip Code:76051-8755
Mailing Address - Country:US
Mailing Address - Phone:817-488-6812
Mailing Address - Fax:817-251-1303
Practice Address - Street 1:2220 BRYAN PL STE 104
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:TX
Practice Address - Zip Code:76065-7127
Practice Address - Country:US
Practice Address - Phone:817-375-0610
Practice Address - Fax:817-375-0640
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NTKC-DFW, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-08-29
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty