Provider Demographics
NPI:1538503735
Name:MADNI, DINA (MD)
Entity Type:Individual
Prefix:DR
First Name:DINA
Middle Name:
Last Name:MADNI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DINA
Other - Middle Name:
Other - Last Name:ITUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:7777 FOREST LANE
Mailing Address - Street 2:SUITE A-331
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230
Mailing Address - Country:US
Mailing Address - Phone:617-913-4522
Mailing Address - Fax:
Practice Address - Street 1:7777 FOREST LANE
Practice Address - Street 2:SUITE A-331
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230
Practice Address - Country:US
Practice Address - Phone:617-913-4522
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-18
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR3873208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery