Healthcare Provider Details

I. General information

NPI: 1750525408
Provider Name (Legal Business Name): NIDA ZAHRA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2009
Last Update Date: 04/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5909 HARRY HINES BLVD SUITE 100
DALLAS TX
75390-9067
US

IV. Provider business mailing address

5909 HARRY HINES BLVD SUITE 100
DALLAS TX
75390-9067
US

V. Phone/Fax

Practice location:
  • Phone: 214-645-3900
  • Fax:
Mailing address:
  • Phone: 214-645-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberP3842
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: