Provider Demographics
NPI:1376799064
Name:ALI, TABREEZ SHIRAAZ (DO)
Entity Type:Individual
Prefix:MR
First Name:TABREEZ
Middle Name:SHIRAAZ
Last Name:ALI
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:PO BOX 36830
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89133-6830
Mailing Address - Country:US
Mailing Address - Phone:702-487-7055
Mailing Address - Fax:702-991-7258
Practice Address - Street 1:28 BROOKRIDGE DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-6620
Practice Address - Country:US
Practice Address - Phone:702-487-7055
Practice Address - Fax:702-991-7258
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-13
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVDO1552208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1376799064Medicaid
NV1376799064Medicaid