Provider Demographics
NPI:1144657578
Name:ALI, SUMERA (PA)
Entity type:Individual
Prefix:
First Name:SUMERA
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6624 FANNIN ST
Mailing Address - Street 2:SUITE 2360
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2315
Mailing Address - Country:US
Mailing Address - Phone:713-794-0500
Mailing Address - Fax:713-794-0946
Practice Address - Street 1:6624 FANNIN ST
Practice Address - Street 2:SUITE 2360
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2315
Practice Address - Country:US
Practice Address - Phone:713-794-0500
Practice Address - Fax:713-794-0946
Is Sole Proprietor?:No
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA08370363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant