Provider Demographics
NPI:1467642009
Name:ABBASI, BUSHRA (MD)
Entity Type:Individual
Prefix:
First Name:BUSHRA
Middle Name:
Last Name:ABBASI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4333 N JOSEY LN
Mailing Address - Street 2:PLAZA II SUITE 101
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4629
Mailing Address - Country:US
Mailing Address - Phone:972-492-1010
Mailing Address - Fax:
Practice Address - Street 1:4333 N JOSEY LN
Practice Address - Street 2:PLAZA II SUITE 101
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4629
Practice Address - Country:US
Practice Address - Phone:972-492-1010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-6568207R00000X
TXQ1546207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR200311200AOtherOK MEDICAID
AR185962001Medicaid
TX3497093-01Medicaid
AR200311200AOtherOK MEDICAID