Provider Demographics
NPI:1134657794
Name:ALI, SAIMA TARIQ (APRN)
Entity Type:Individual
Prefix:MRS
First Name:SAIMA
Middle Name:TARIQ
Last Name:ALI
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2417 SAFFIRE WAY
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75056-6561
Mailing Address - Country:US
Mailing Address - Phone:817-715-3774
Mailing Address - Fax:
Practice Address - Street 1:12200 PARK CENTRAL DR STE 100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2124
Practice Address - Country:US
Practice Address - Phone:469-804-8323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-26
Last Update Date:2018-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134030363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily