Provider Demographics
NPI:1417131079
Name:AHMAD, SYED ALI (MAC, LAC)
Entity Type:Individual
Prefix:MR
First Name:SYED
Middle Name:ALI
Last Name:AHMAD
Suffix:
Gender:M
Credentials:MAC, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 797012
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75379-7012
Mailing Address - Country:US
Mailing Address - Phone:972-612-7961
Mailing Address - Fax:
Practice Address - Street 1:2800 W PARKER RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75075-9194
Practice Address - Country:US
Practice Address - Phone:972-612-7961
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAC00408171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist