Provider Demographics
NPI:1225596018
Name:MALIK M ALI LLC
Entity Type:Organization
Organization Name:MALIK M ALI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:MALIK
Authorized Official - Middle Name:M
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:210-417-4595
Mailing Address - Street 1:2003 COURTLAND DR
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-3634
Mailing Address - Country:US
Mailing Address - Phone:210-417-4595
Mailing Address - Fax:
Practice Address - Street 1:2003 COURTLAND DR
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-3634
Practice Address - Country:US
Practice Address - Phone:817-296-6224
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty