Provider Demographics
NPI:1982639589
Name:DUSA, NARCISA ADINA (MD)
Entity Type:Individual
Prefix:
First Name:NARCISA
Middle Name:ADINA
Last Name:DUSA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3941 LEGACY DR # 204-A223
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75023-8334
Mailing Address - Country:US
Mailing Address - Phone:469-215-2415
Mailing Address - Fax:469-210-7532
Practice Address - Street 1:7713 SAN JACINTO PL STE 300
Practice Address - Street 2:
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75024-3379
Practice Address - Country:US
Practice Address - Phone:469-215-2415
Practice Address - Fax:469-210-7532
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXM0710207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7908655OtherAETNA
TX171383601Medicaid
TX171383602Medicaid
TX8R5834OtherBCBS TX
TXP00693973Medicare UPIN
TX8G7218Medicare PIN
TX613311Medicare PIN
TX473173Medicare PIN
TX8R5834OtherBCBS TX
TX613311Medicare UPIN