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General NPI Number Information
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NPI Number | 1396250577
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Entity Type | Organization
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Legal Business Name | NORTH DALLAS HEALTHCARE ASSOCIATES LLC
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Dates
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Enumeration Date | 12/09/2017
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Last Update Date | 12/09/2017
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Provider Practice Location Address
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Address Line | 4040 LEGACY DR STE 104
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City | FRISCO
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State | TX
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Zip | 75034-6748
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Country | US
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Telephone | 469-200-8046
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Fax |
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Provider Business Mailing Address
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Address Line | 4040 LEGACY DR STE 104
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City | FRISCO
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State | TX
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Zip | 75034-6748
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | DR. OUSAMA MOAMMAR
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Credential | MD
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Telephone | 214-471-2808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | N5873
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License Number State | TX
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