Provider Demographics
NPI:1891944252
Name:ALI JAHAN-TIGH MD PA
Entity Type:Organization
Organization Name:ALI JAHAN-TIGH MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEOFFREY
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:JAHAN-TIGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-425-6965
Mailing Address - Street 1:PO BOX 1668
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77522-1668
Mailing Address - Country:US
Mailing Address - Phone:281-425-6965
Mailing Address - Fax:832-556-2925
Practice Address - Street 1:4310 GARTH RD
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3114
Practice Address - Country:US
Practice Address - Phone:281-425-6965
Practice Address - Fax:832-556-2925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5356207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1164544227OtherNATIONAL PLAN AND PROVIDER ENUMERATION SYSTEM NPPES