Provider Demographics
NPI:1629311774
Name:JAFRI, MOHAMMAD ALI SYED (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMMAD ALI
Middle Name:SYED
Last Name:JAFRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:601 E SAN ANTONIO ST STE 101W
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-6004
Practice Address - Country:US
Practice Address - Phone:361-485-9600
Practice Address - Fax:361-485-9610
Is Sole Proprietor?:No
Enumeration Date:2013-03-27
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXS5666207R00000X, 207RX0202X, 207RH0003X, 207RX0202X
CT055637208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX421969301Medicaid
TX421969303Medicaid
TX421969302Medicaid