Provider Demographics
NPI:1841605706
Name:SHAHLA ALI MD PA
Entity Type:Organization
Organization Name:SHAHLA ALI MD PA
Other - Org Name:ALLEN PSYCHIATRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAHLA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:469-340-2777
Mailing Address - Street 1:1774 W MCDERMOTT DR STE 150
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-3424
Mailing Address - Country:US
Mailing Address - Phone:469-340-2777
Mailing Address - Fax:469-208-0230
Practice Address - Street 1:1774 W MCDERMOTT DR STE 150
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-3424
Practice Address - Country:US
Practice Address - Phone:469-340-2777
Practice Address - Fax:469-208-0230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-30
Last Update Date:2019-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP97892084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty