Provider Demographics
NPI:1851949804
Name:SOOMRO, AILA MUNAWAR
Entity Type:Individual
Prefix:
First Name:AILA
Middle Name:MUNAWAR
Last Name:SOOMRO
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 1:3817 CAMINO DR
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75074-3445
Mailing Address - Country:US
Mailing Address - Phone:214-554-2351
Mailing Address - Fax:
Practice Address - Street 1:3600 GASTON AVE STE 550
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1905
Practice Address - Country:US
Practice Address - Phone:469-800-7974
Practice Address - Fax:214-821-1193
Is Sole Proprietor?:No
Enumeration Date:2019-09-03
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA13341363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant