Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ayesha Khadeeruddin

Individual provider Pediatric Cardiology Physician · NPI 1376416255

Ayesha Khadeeruddin is a Physician Assistant in Dallas, Texas. Qualified in 2024, 2 years ago. Licensed in Texas.

Years since qualifying
2
Licensed in
TX
In the registry since
2025
Specialties on file
2

Practice location Address checks out

1935 Medical District Dr
Dallas, TX 75235-7701
Phone: (214) 456-7000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA19429 (TX)
Pediatric Cardiology Physician Taxonomy 2080P0202X · Licence PA19429 (TX)

Record details

NPI number1376416255
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedSeptember 26, 2025
Last updated in NPPESJanuary 15, 2026
Certification dateJanuary 15, 2026
Mailing address7726 Temperance Dr, Fayetteville, NC 28314-6359

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated

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