Provider Demographics
NPI:1891944617
Name:ANSARI, SHARIQUE ASLAM (MD, MPH)
Entity Type:Individual
Prefix:
First Name:SHARIQUE
Middle Name:ASLAM
Last Name:ANSARI
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:SHARIQUE
Other - Middle Name:
Other - Last Name:ASLAM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD, MPH
Mailing Address - Street 1:1305 AIRPORT FWY
Mailing Address - Street 2:SUITE 205
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76021-6605
Mailing Address - Country:US
Mailing Address - Phone:817-267-6290
Mailing Address - Fax:817-267-0950
Practice Address - Street 1:1305 AIRPORT FWY
Practice Address - Street 2:SUITE 205
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-6605
Practice Address - Country:US
Practice Address - Phone:817-267-6290
Practice Address - Fax:817-267-0950
Is Sole Proprietor?:No
Enumeration Date:2008-09-17
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ25052084N0008X, 2084N0400X
SD85422084N0400X
NE59482084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0008XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeuromuscular Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology