Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | Q7494 | TX |
NPI | 1083031421 |
---|---|
Provider Name | Mr. Mohammad Ali Ursani |
First Address | Kingwood, TX 77339-6009 |
Second Address | The Woodlands, TX 77380-3485 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2014 |
Last Update Date | 12/04/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
371422201 | (05) | TX |