Provider Demographics
NPI:1932469350
Name:DAHDAL, DINA (MD)
Entity type:Individual
Prefix:
First Name:DINA
Middle Name:
Last Name:DAHDAL
Suffix:
Gender:U
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 RAINBOW DR # 10451
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77399-9301
Mailing Address - Country:US
Mailing Address - Phone:936-200-4471
Mailing Address - Fax:
Practice Address - Street 1:8619 CHICOT RD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72209-4445
Practice Address - Country:US
Practice Address - Phone:501-850-6288
Practice Address - Fax:501-850-6927
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK34321208100000X
MI4301100660208600000X, 390200000X
ARE-9957208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No208600000XAllopathic & Osteopathic PhysiciansSurgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program