Provider Demographics
NPI:1386437572
Name:DUSOUGI MOHAMED, SARA (PA)
Entity type:Individual
Prefix:MRS
First Name:SARA
Middle Name:
Last Name:DUSOUGI MOHAMED
Suffix:
Gender:X
Credentials:PA
Other - Prefix:
Other - First Name:NA
Other - Middle Name:
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:8123 POLARIS PT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78252-2373
Mailing Address - Country:US
Mailing Address - Phone:727-415-6239
Mailing Address - Fax:
Practice Address - Street 1:503 MED CT # 210
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-3493
Practice Address - Country:US
Practice Address - Phone:210-494-4290
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA19169363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant