Provider Demographics
NPI:1093935975
Name:LADHA, ALIM MIRZA (MD)
Entity Type:Individual
Prefix:
First Name:ALIM
Middle Name:MIRZA
Last Name:LADHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 13562
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79768-3562
Mailing Address - Country:US
Mailing Address - Phone:432-617-4551
Mailing Address - Fax:432-687-6299
Practice Address - Street 1:8050 E HIGHWAY 191
Practice Address - Street 2:STE 203
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79765-8615
Practice Address - Country:US
Practice Address - Phone:432-617-4551
Practice Address - Fax:432-687-6298
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXP0750207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery