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General NPI Number Information
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NPI Number | 1861623951
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Entity Type | Individual
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Provider Name | ASMA ASHIQALI BHAIDANI PA-C
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Gender | Female
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Dates
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Enumeration Date | 08/06/2009
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Last Update Date | 01/08/2019
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Provider Practice Location Address
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Address Line | 4125 FAIRWAY DR STE 190
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City | CARROLLTON
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State | TX
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Zip | 75010
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Country | US
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Telephone | 469-431-0486
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Fax | 972-395-3383
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Provider Business Mailing Address
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Address Line | 4125 FAIRWAY DR STE 190
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City | CARROLLTON
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State | TX
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Zip | 75010-6506
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Country | US
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Telephone | 469-431-0486
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Fax | 972-395-3383
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA07856
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 085003389
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License Number State | IL
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