Provider Demographics
NPI:1356359814
Name:ALI, YASMEEN (MD)
Entity type:Individual
Prefix:
First Name:YASMEEN
Middle Name:
Last Name:ALI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E UNIVERSITY AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-6821
Mailing Address - Country:US
Mailing Address - Phone:877-800-5722
Mailing Address - Fax:
Practice Address - Street 1:200 NOLA RUTH BLVD
Practice Address - Street 2:
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-6074
Practice Address - Country:US
Practice Address - Phone:877-800-5722
Practice Address - Fax:254-698-1673
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5769208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX100839301Medicaid
TX8069KOMedicare ID - Type Unspecified
TX100839301Medicaid