Provider Demographics
NPI:1124379516
Name:WASSERZUG, OSHRI (MD)
Entity Type:Individual
Prefix:
First Name:OSHRI
Middle Name:
Last Name:WASSERZUG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2350 N STEMMONS FWY
Mailing Address - Street 2:SUITE F6.203
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75207-2700
Mailing Address - Country:US
Mailing Address - Phone:214-456-3978
Mailing Address - Fax:214-456-7644
Practice Address - Street 1:2350 N STEMMONS FWY
Practice Address - Street 2:SUITE F6.203
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75207-2700
Practice Address - Country:US
Practice Address - Phone:214-456-3978
Practice Address - Fax:214-456-7644
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10044944207YP0228X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology