Provider Demographics
NPI:1396062600
Name:ALI, ADIL R (MD)
Entity type:Individual
Prefix:
First Name:ADIL
Middle Name:R
Last Name:ALI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:915 GESSNER RD STE 360
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2540
Mailing Address - Country:US
Mailing Address - Phone:713-468-5440
Mailing Address - Fax:713-973-0778
Practice Address - Street 1:915 GESSNER RD STE 360
Practice Address - Street 2:SUITE 360
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2540
Practice Address - Country:US
Practice Address - Phone:713-468-5440
Practice Address - Fax:713-973-0778
Is Sole Proprietor?:No
Enumeration Date:2010-04-26
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP5322207R00000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX348288701Medicaid