Provider Demographics
NPI:1720196983
Name:DUSARA CORPORATION
Entity Type:Organization
Organization Name:DUSARA CORPORATION
Other - Org Name:UNIVERSALMED SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF OPERATIONS
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJESH
Authorized Official - Middle Name:B
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-228-1820
Mailing Address - Street 1:1329 W WALNUT HILL LN STE 100
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-3027
Mailing Address - Country:US
Mailing Address - Phone:972-228-1820
Mailing Address - Fax:972-572-1112
Practice Address - Street 1:1329 W WALNUT HILL LN STE 100
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-3027
Practice Address - Country:US
Practice Address - Phone:972-228-1820
Practice Address - Fax:972-572-1112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-28
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1000937332B00000X, 332B00000X
332BC3200X, 332BX2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4363290001Medicare NSC