Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PE0004X | Emergency Medical Services | K1769 | TX |
N | 207R00000X | Internist | K1769 | TX |
N | 111NI0900X | Internist | K1769 | TX |
NPI | 1013968064 |
---|---|
Provider Name | Syed S Ali |
First Address | Missouri City, TX 77459-6057 |
Second Address | Port Arthur, TX 77640-7002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2006 |
Last Update Date | 21/07/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F63168 | (02) | TX |