Provider Demographics
NPI:1861623951
Name:BHAIDANI, ASMA ASHIQALI (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ASMA
Middle Name:ASHIQALI
Last Name:BHAIDANI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4125 FAIRWAY DR STE 190
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-6506
Mailing Address - Country:US
Mailing Address - Phone:469-431-0486
Mailing Address - Fax:972-395-3383
Practice Address - Street 1:4125 FAIRWAY DR STE 190
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010
Practice Address - Country:US
Practice Address - Phone:469-431-0486
Practice Address - Fax:972-395-3383
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2019-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07856363A00000X
IL085003389363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant