MEDICARE: DARA ABUSADA DDS

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
1	1223G0001X	General Practice Dentistry	30013	TX
2	122300000X	Dentist	30013	TX

General Provider Information

NPI Number	:	1265847222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DARA ABUSADA DDS

Provider Business Mailing Address
First Line	:	2403 LACY LN
Second Line	:
City	:	CARROLLTON
State	:	TX
Zip	:	75006-6514
Country	:	US
Telephone Number	:	972-869-3789
Fax Number	:

Provider Business Practice Location Address
First Line	:	2402 RICE BLVD
Second Line	:	C
City	:	HOUSTON
State	:	TX
Zip	:	77005-3203
Country	:	US
Telephone Number	:	281-833-0101
Fax Number	:	281-833-0102

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/27/2014
Last Update Date	:	01/10/2023

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