Provider Demographics
NPI:1144434010
Name:ALI, SYED M (MBBS, MD)
Entity type:Individual
Prefix:DR
First Name:SYED
Middle Name:M
Last Name:ALI
Suffix:
Gender:M
Credentials:MBBS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1600 WATERS RIDGE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75057-6039
Mailing Address - Country:US
Mailing Address - Phone:972-219-0558
Mailing Address - Fax:972-436-9273
Practice Address - Street 1:1600 WATERS RIDGE DR
Practice Address - Street 2:SUITE A
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75057-6039
Practice Address - Country:US
Practice Address - Phone:972-219-0558
Practice Address - Fax:972-436-9273
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2013-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT-183294207R00000X
TXP2822174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty