Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | L7642 | TX |
NPI | 1003816315 |
---|---|
Provider Name | Dr. Shamim Ali |
First Address | Katy, TX 77450-2256 |
Second Address | Katy, TX 77450-2256 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 09/05/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
170793701 | (05) | TX |
22369 | MEMORIAL HERMANN HEALTHCARE (01) | TX |
7142667 | AETNA (01) | TX |
8R6350 | BCBS (01) | TX |
H76796 | (02) | TX |