Provider Demographics
NPI:1578724811
Name:BHUSARI, VAISHALI KAWADUJI (MD)
Entity Type:Individual
Prefix:DR
First Name:VAISHALI
Middle Name:KAWADUJI
Last Name:BHUSARI
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 1:4555 LORRAINE AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-3612
Mailing Address - Country:US
Mailing Address - Phone:214-755-5587
Mailing Address - Fax:
Practice Address - Street 1:4555 LORRAINE AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-3612
Practice Address - Country:US
Practice Address - Phone:214-755-5587
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-19
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPO348282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX285905YNJCMedicare PIN