Provider Demographics
NPI:1972008050
Name:AL ANI, AHMED
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:AL ANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:AHMED
Other - Middle Name:
Other - Last Name:AL-ANI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1 SIGNATURE POINT DR APT 1002
Mailing Address - Street 2:
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573-6522
Mailing Address - Country:US
Mailing Address - Phone:619-576-6423
Mailing Address - Fax:
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-4529
Practice Address - Country:US
Practice Address - Phone:409-772-0750
Practice Address - Fax:409-747-0777
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-29
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXBP10074400207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program