Provider Demographics
NPI:1003707563
Name:DABBOURA, LINDA
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:DABBOURA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 SULLIVAN TRL
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18040-8354
Mailing Address - Country:US
Mailing Address - Phone:610-258-6666
Mailing Address - Fax:610-515-1679
Practice Address - Street 1:2020 SULLIVAN TRL
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18040-8354
Practice Address - Country:US
Practice Address - Phone:610-258-6666
Practice Address - Fax:610-515-1679
Is Sole Proprietor?:No
Enumeration Date:2025-07-14
Last Update Date:2025-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG004276152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist