MEDICARE: LINA N. AL-DAHHAN MD

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	208000000X	Pediatrics Physician	K2398	TX

General Provider Information

NPI Number	:	1598754954
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINA N. AL-DAHHAN MD

Provider Business Mailing Address
First Line	:	3705 WAGON WHEEL CT
Second Line	:
City	:	RICHARDSON
State	:	TX
Zip	:	75082-2679
Country	:	US
Telephone Number	:	409-767-1111
Fax Number	:	469-304-0284

Provider Business Practice Location Address
First Line	:	2825 BELT LINE RD STE 103
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75044-7011
Country	:	US
Telephone Number	:	469-814-0456
Fax Number	:	469-304-0284

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

Provider Enumeration Date	:	10/18/2005
Last Update Date	:	06/04/2021

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