Provider Demographics
NPI:1922011782
Name:NASUR, ALI M (MD)
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:M
Last Name:NASUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1840 JOE BATTLE BLVD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-0962
Mailing Address - Country:US
Mailing Address - Phone:915-249-4344
Mailing Address - Fax:915-307-2765
Practice Address - Street 1:1840 JOE BATTLE BLVD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-0962
Practice Address - Country:US
Practice Address - Phone:915-249-4344
Practice Address - Fax:915-307-2765
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP4685207RI0011X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3167504-01Medicaid
TX3167504-01Medicaid