Provider Demographics
NPI:1598546962
Name:ALI, SAFA MUHAMMAD
Entity Type:Individual
Prefix:
First Name:SAFA
Middle Name:MUHAMMAD
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 1:24810 BOULDER LAKES CT
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3900
Mailing Address - Country:US
Mailing Address - Phone:281-777-3428
Mailing Address - Fax:
Practice Address - Street 1:6445 FM 1463 RD STE 230
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-4031
Practice Address - Country:US
Practice Address - Phone:281-346-8370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical