Provider Demographics
NPI:1083698641
Name:ALAMGIR, NUSRAT T (MD)
Entity Type:Individual
Prefix:
First Name:NUSRAT
Middle Name:T
Last Name:ALAMGIR
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:PO BOX 660599
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75266-0599
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9202 ELAM RD
Practice Address - Street 2:SOUTHEAST DALLAS HEALTH CENTER
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75217-4151
Practice Address - Country:US
Practice Address - Phone:214-266-1600
Practice Address - Fax:214-266-1790
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2013-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ3715208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX105604608Medicaid
TX105604607Medicaid
TX105604613Medicaid
TX105604609Medicaid
TX105604612Medicaid
TX105604614Medicaid
TX8743J1OtherBLUE CROSS BLUE SHIELD
TX105604610Medicaid
TX105604611Medicaid
TX105604604Medicaid
TX105604602Medicaid
TX105604605Medicaid
TX105604614Medicaid
TX105604610Medicaid