Provider Demographics
NPI:1972646651
Name:ALI, RAFIQ QASAM (MD, DC)
Entity Type:Individual
Prefix:DR
First Name:RAFIQ
Middle Name:QASAM
Last Name:ALI
Suffix:
Gender:M
Credentials:MD, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5110 BUFFALO SPEEDWAY STE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-4220
Mailing Address - Country:US
Mailing Address - Phone:713-363-7460
Mailing Address - Fax:713-660-0683
Practice Address - Street 1:5110 BUFFALO SPEEDWAY STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-4220
Practice Address - Country:US
Practice Address - Phone:713-363-7460
Practice Address - Fax:713-660-0683
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2017-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0859207Q00000X
TX8786111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX342498802Medicaid