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NPI Code Detail

MEDICARE: ASRA ALBAYATTI DMD

MEDICARE: ASRA ALBAYATTI DMD
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
1122300000XDentist2901021532MI
21223G0001XGeneral Practice Dentistry35895TX

General Provider Information

NPI Number : 1407237985
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASRA ALBAYATTI DMD
Provider Business Mailing Address
First Line : 3030 LBJ FWY STE 1700
Second Line :
City : DALLAS
State : TX
Zip : 75234-2759
Country : US
Telephone Number : 972-444-8888
Fax Number :
Provider Business Practice Location Address
First Line : 3030 LBJ FWY STE 1700
Second Line :
City : DALLAS
State : TX
Zip : 75234-2759
Country : US
Telephone Number : 972-444-8888
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2015
Last Update Date : 05/05/2023

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