Provider Demographics
NPI:1417023771
Name:ALI, FARIDA (OD)
Entity Type:Individual
Prefix:DR
First Name:FARIDA
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7011 ESCONDIDO DR
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76016-5421
Mailing Address - Country:US
Mailing Address - Phone:817-572-7251
Mailing Address - Fax:
Practice Address - Street 1:2301 N COLLINS ST
Practice Address - Street 2:# 124
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-2659
Practice Address - Country:US
Practice Address - Phone:817-860-9050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6732TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist