Provider Demographics
NPI:1235024761
Name:NASIR, ALI
Entity type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:NASIR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4931 LOCKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:PROSPER
Mailing Address - State:TX
Mailing Address - Zip Code:75078-1512
Mailing Address - Country:US
Mailing Address - Phone:309-501-1259
Mailing Address - Fax:
Practice Address - Street 1:200 S WENONA ST STE 195
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-8820
Practice Address - Country:US
Practice Address - Phone:313-497-2665
Practice Address - Fax:313-583-7002
Is Sole Proprietor?:No
Enumeration Date:2025-06-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician