Healthcare Provider Details

I. General information

NPI: 1699412395
Provider Name (Legal Business Name): MRS. HAFSA HASSAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2022
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18101 OAKWOOD BLVD
DEARBORN MI
48124-4089
US

IV. Provider business mailing address

6789 BARNES DR
FRISCO TX
75034-9723
US

V. Phone/Fax

Practice location:
  • Phone: 214-808-2170
  • Fax:
Mailing address:
  • Phone: 214-808-2170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number47510
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4351049590
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: