Provider Demographics
NPI:1538818109
Name:ALI, REIZA RASHAD (DO)
Entity type:Individual
Prefix:
First Name:REIZA
Middle Name:RASHAD
Last Name:ALI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3450 W WHEATLAND RD STE 343
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-4416
Mailing Address - Country:US
Mailing Address - Phone:972-283-3733
Mailing Address - Fax:972-283-3738
Practice Address - Street 1:3450 W WHEATLAND RD STE 343
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-4416
Practice Address - Country:US
Practice Address - Phone:972-283-3737
Practice Address - Fax:972-283-3738
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXU9814390200000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program