Provider Demographics
NPI:1457626947
Name:ALI, NUSRAT
Entity Type:Individual
Prefix:
First Name:NUSRAT
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20320 NORTHWEST FWY
Mailing Address - Street 2:SUITE 900
Mailing Address - City:JERSEY VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:77065-5641
Mailing Address - Country:US
Mailing Address - Phone:281-453-7224
Mailing Address - Fax:281-440-2020
Practice Address - Street 1:7202 BORDACE CT
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-1602
Practice Address - Country:US
Practice Address - Phone:281-875-1800
Practice Address - Fax:281-440-2020
Is Sole Proprietor?:No
Enumeration Date:2012-03-15
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1207330225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist