Provider Demographics
NPI:1184143828
Name:DAGHLAS, ALAA ABDALLA (PA-C)
Entity type:Individual
Prefix:
First Name:ALAA
Middle Name:ABDALLA
Last Name:DAGHLAS
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:221 W. COLORADO BLVD.
Mailing Address - Street 2:PAVILION II SUITE 425
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208
Mailing Address - Country:US
Mailing Address - Phone:214-947-3231
Mailing Address - Fax:214-947-3239
Practice Address - Street 1:221 W. COLORADO BLVD.
Practice Address - Street 2:PAVILION II SUITE 425
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208
Practice Address - Country:US
Practice Address - Phone:214-947-3231
Practice Address - Fax:214-947-3239
Is Sole Proprietor?:No
Enumeration Date:2017-09-13
Last Update Date:2021-10-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA14177363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXPA14177OtherPA