Provider Demographics
NPI:1134123862
Name:AZIMPOOR, ALI (MD)
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:AZIMPOOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1140 BUSINESS CENTER DR
Mailing Address - Street 2:SUITE 490
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77043-2737
Mailing Address - Country:US
Mailing Address - Phone:713-932-1247
Mailing Address - Fax:713-932-1887
Practice Address - Street 1:1140 BUSINESS CENTER DR
Practice Address - Street 2:SUITE 490
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77043-2737
Practice Address - Country:US
Practice Address - Phone:713-932-1247
Practice Address - Fax:713-932-1887
Is Sole Proprietor?:No
Enumeration Date:2005-06-10
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3846208600000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB146822Medicare PIN
TXTXB146821Medicare PIN
TXB21038Medicare UPIN