Basic Information
Provider Information
NPI: 1902035686
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KASSAR
FirstName: DARINE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 440 RAYNOLDS ST
Address2:  
City: EL PASO
State: TX
PostalCode: 799051613
CountryCode: US
TelephoneNumber: 9152154480
FaxNumber:  
Practice Location
Address1: 4801 ALBERTA AVE
Address2:  
City: EL PASO
State: TX
PostalCode: 799052707
CountryCode: US
TelephoneNumber: 9152155900
FaxNumber: 9155456607
Other Information
ProviderEnumerationDate: 07/02/2009
LastUpdateDate: 01/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400XP8922TXN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
2084N0008XP8922TXY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine

No ID Information.


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