Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223G0001X | General Practice | 054876 | NY |
N | 213EG0000X | General Practice | 054876 | NY |
N | 1223G0001X | General Practice | 8611 | KY |
N | 213EG0000X | General Practice | 8611 | KY |
N | 1223S0112X | Oral and Maxillofacial Surgeon | 30.023877 | OH |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 30759 | TX |
NPI | 1053579771 |
---|---|
Provider Name | Dr. Ahmad Ali Millwala |
First Address | Houston, TX 77095-7196 |
Second Address | Katy, TX 77449-5563 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2008 |
Last Update Date | 16/06/2018 |