Provider Demographics
NPI:1184945735
Name:HUSSAIN, INSIYA ABID (DDS)
Entity type:Individual
Prefix:DR
First Name:INSIYA
Middle Name:ABID
Last Name:HUSSAIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6910 HART LN
Mailing Address - Street 2:#607
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4150
Mailing Address - Country:US
Mailing Address - Phone:512-484-6786
Mailing Address - Fax:
Practice Address - Street 1:5110 AVENUE H STE M05
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471-2014
Practice Address - Country:US
Practice Address - Phone:832-595-0022
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-17
Last Update Date:2010-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25453122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist