Provider Demographics
NPI:1548439888
Name:MAHMOOD, ALI (MD)
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:MAHMOOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:16605 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 430
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3501
Mailing Address - Country:US
Mailing Address - Phone:281-242-3300
Mailing Address - Fax:281-242-3330
Practice Address - Street 1:16605 SOUTHWEST FWY
Practice Address - Street 2:SUITE 430
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3501
Practice Address - Country:US
Practice Address - Phone:281-242-3300
Practice Address - Fax:281-242-3330
Is Sole Proprietor?:No
Enumeration Date:2008-02-20
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301082545208600000X
TXN3155208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX350783201Medicaid
TX8GD965OtherBCBS
TX8FG745OtherBLUE CROSS BLUE SHIELD
TX350783202Medicaid
TX350783204Medicaid
TX350783201Medicaid
TX350783204Medicaid
TX436030YQ64Medicare PIN
TX350783202Medicaid