Provider Demographics
NPI:1548555642
Name:ALI, NIDA FATEMA (MD)
Entity type:Individual
Prefix:DR
First Name:NIDA
Middle Name:FATEMA
Last Name:ALI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8307 KNIGHT RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-3905
Mailing Address - Country:US
Mailing Address - Phone:713-242-7707
Mailing Address - Fax:713-796-9779
Practice Address - Street 1:8307 KNIGHT RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-3905
Practice Address - Country:US
Practice Address - Phone:713-242-7707
Practice Address - Fax:713-796-9779
Is Sole Proprietor?:No
Enumeration Date:2011-06-16
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6766207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine