Provider Demographics
NPI:1548214430
Name:HUSSAIN, HASINA (MD)
Entity Type:Individual
Prefix:
First Name:HASINA
Middle Name:
Last Name:HUSSAIN
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 1:600 W. MCDERMOTT DR
Mailing Address - Street 2:STE B
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-2700
Mailing Address - Country:US
Mailing Address - Phone:972-359-0000
Mailing Address - Fax:972-359-1000
Practice Address - Street 1:600 W. MCDERMOTT DR
Practice Address - Street 2:STE B
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-2700
Practice Address - Country:US
Practice Address - Phone:972-359-0000
Practice Address - Fax:972-359-1000
Is Sole Proprietor?:No
Enumeration Date:2006-05-22
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ70092080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX113473604Medicaid
TX113473604Medicaid