Provider Demographics
NPI:1598497067
Name:ABUSAAD, HADI A (OD)
Entity Type:Individual
Prefix:
First Name:HADI
Middle Name:A
Last Name:ABUSAAD
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 LUCAS DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-1804
Mailing Address - Country:US
Mailing Address - Phone:214-528-1354
Mailing Address - Fax:214-528-7387
Practice Address - Street 1:2525 LUCAS DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-1804
Practice Address - Country:US
Practice Address - Phone:214-528-1354
Practice Address - Fax:214-528-7387
Is Sole Proprietor?:No
Enumeration Date:2022-06-24
Last Update Date:2022-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10603152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10603OtherOPTOMETRY LICENSE