Provider Demographics
NPI:1720242332
Name:AVAS MEDICINE
Entity Type:Organization
Organization Name:AVAS MEDICINE
Other - Org Name:AVAS MEDICINE PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NARCISA
Authorized Official - Middle Name:ADINA
Authorized Official - Last Name:DUSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-981-7270
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:972-981-7270
Mailing Address - Fax:972-981-7271
Practice Address - Street 1:6300 W PARKER RD
Practice Address - Street 2:MOB2 SUITE 222
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8100
Practice Address - Country:US
Practice Address - Phone:972-981-7270
Practice Address - Fax:972-981-7271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-12
Last Update Date:2016-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0710261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX473172Medicare UPIN
473173ZS85Medicare PIN