Provider Demographics
NPI:1649521873
Name:AALEYA KOREISHI MD PA
Entity type:Organization
Organization Name:AALEYA KOREISHI MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AALEYA
Authorized Official - Middle Name:F
Authorized Official - Last Name:KOREISHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-505-3868
Mailing Address - Street 1:801 ROAD TO SIX FLAGS W STE 131
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-2600
Mailing Address - Country:US
Mailing Address - Phone:817-987-1248
Mailing Address - Fax:
Practice Address - Street 1:801 ROAD TO SIX FLAGS W STE 131
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2600
Practice Address - Country:US
Practice Address - Phone:817-987-1248
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-27
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM9427207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty