Provider Demographics
NPI:1962480632
Name:ALI, BASIT (DO)
Entity Type:Individual
Prefix:
First Name:BASIT
Middle Name:
Last Name:ALI
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:3500 W WHEATLAND RD
Mailing Address - Street 2:GROUND FLR, POB #3
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75237-3460
Mailing Address - Country:US
Mailing Address - Phone:214-947-0752
Mailing Address - Fax:214-947-0751
Practice Address - Street 1:3500 W WHEATLAND RD
Practice Address - Street 2:GROUND FLR, POB #3
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3460
Practice Address - Country:US
Practice Address - Phone:214-947-0752
Practice Address - Fax:214-947-0751
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2014-09-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM0340207QG0300X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
No207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F5054Medicare PIN
H76431Medicare UPIN