Provider Demographics
NPI:1871562272
Name:ALI, SHANAZ K (MD)
Entity type:Individual
Prefix:
First Name:SHANAZ
Middle Name:K
Last Name:ALI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1111 HIGHWAY 6 STE 150
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-4913
Mailing Address - Country:US
Mailing Address - Phone:281-491-0909
Mailing Address - Fax:281-491-0712
Practice Address - Street 1:1111 HIGHWAY 6
Practice Address - Street 2:SUITE 100
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4914
Practice Address - Country:US
Practice Address - Phone:281-491-0909
Practice Address - Fax:281-491-0712
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL9062208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXI23726Medicare UPIN