MEDICARE: DR. MOHAMAD DEYAA DABBAGH DO

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	2084P0800X	Psychiatry Physician	V8843	TX
2	2084P2900X	Pain Medicine (Psychiatry & Neurology) Physician	3206	NV
3	208VP0014X	Interventional Pain Medicine Physician	V8843	TX
4	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1902433402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOHAMAD DEYAA DABBAGH DO

Provider Business Mailing Address
First Line	:	9260 W SUNSET RD STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4903
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9260 W SUNSET RD STE 110
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89148-4903
Country	:	US
Telephone Number	:	702-916-6906
Fax Number	:

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

Provider Enumeration Date	:	03/25/2020
Last Update Date	:	12/29/2025

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Directions to “ DR. MOHAMAD DEYAA DABBAGH DO” Practice Location

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