Provider Demographics
NPI:1891484747
Name:SAMNANI, ALISHA ALI
Entity Type:Individual
Prefix:
First Name:ALISHA
Middle Name:ALI
Last Name:SAMNANI
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 1:2315 HOLDER DR
Mailing Address - Street 2:
Mailing Address - City:EULESS
Mailing Address - State:TX
Mailing Address - Zip Code:76039-4361
Mailing Address - Country:US
Mailing Address - Phone:682-559-4125
Mailing Address - Fax:
Practice Address - Street 1:3417 GASTON AVE
Practice Address - Street 2:STE 1000 & 1100
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246
Practice Address - Country:US
Practice Address - Phone:469-800-9000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-05
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSTUDENT363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical